Michael Wesley Beaty, MD
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Winston Salem, NC
NPI 1770567208 · NPPES record last updated Aug 19, 2010
Key facts
- NPI
- 1770567208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 2000-01060 (NC)
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-2255
- Fax
- (336) 716-7595
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Michigan State University College of Human Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wake Forest University Health Sciences
Practice addresses (Care Compare)
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
Hospital & facility affiliations
- North Carolina Baptist Hospital
- High Point Regional Health System
- Wilkes Regional Medical Center
- Moses H. Cone Memorial Hospital, the
- Lexington Memorial Hospital Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100311000524 | NC | Practitioner - Pathology | 3173668464 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000-01060 | NC | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current |
Accepting new patients | |
| Wake Forest University Health Sciences | Current |
Accepting new patients |
Locations
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- mbeaty2754013@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 2000-01060 | NC | Yes |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9801176000 | Medicaid | WV | |
| 1263N | Other | BCBS | |
| 37160 | Other | PARTNERS | |
| 99592 | Other | MEDCOST | |
| 7708650 | Other | AETNA | |
| 891263N | Medicaid | NC | |
| Q01060 | Medicaid | SC | |
| 6600751 | Medicaid | VA |
Other providers in Winston Salem, NC
- Melanie Martucci Bearror
- Jennifer Beatty
- Jennifer Beatty
- Marina Beatty
- Reilly Beatty
- Rachel Day Beauchamp
- Bryan Paul Beaver
- Lauren Ray Beaver
- Abby Lynn Becherer Bartholomew
- Robert Edmond Bechtold
All providers in Winston Salem, NC · Anatomic Pathology & Clinical Pathology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.