Individual provider Active NPI

Kinley Danae Beck, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Portsmouth, NH
National Provider Identifier
1770840365
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
54082 Issued in TN
Practice address
155 Borthwick Ave Ste 200E
Portsmouth, NH 03801-4184
Phone
(603) 436-1773
Fax
(603) 427-0655
NPI assigned
Apr 19, 2012
Last updated
May 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10047004 TX
Ophthalmology Physician 207W00000X R4518 TX
Ophthalmology Physician 207W00000X 24382 MS
Ophthalmology Physician 207W00000X E9764 AR
Ophthalmology Physician 207W00000X 54082 TN
Retina Specialist (Ophthalmology) Physician 207WX0107X E9764 AR
Retina Specialist (Ophthalmology) Physician 207WX0107X 24382 MS
Retina Specialist (Ophthalmology) Physician 207WX0107X 19236 NH
Retina Specialist (Ophthalmology) Physician 207WX0107X 54082 TN Primary

Addresses

Primary practice location

155 Borthwick Ave Ste 200E
Portsmouth, NH 03801-4184

Mailing address

155 Borthwick Ave Ste 200E
Portsmouth, NH 03801-4184
Phone (603) 436-1773

Other practice location 1

825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone (901) 685-2200

Other practice location 2

825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone (901) 685-2200

Other practice location 3

8300 Floyd Curl Dr Fl 6
San Antonio, TX 78229-3931
Phone (210) 450-9400

Other identifiers 6

IdentifierTypeStateIssuer
214078001MedicaidAR
376236101MedicaidTX
3118506MedicaidNH
07208203MedicaidMS
376236102OtherTXCSHCN
Q022120MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190628000762 NH Practitioner - Ophthalmology 8123318383 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyesight Ophthalmic Services PLLCGroup PAC ID 3971588609, 16 clinicians

Practice addresses (Care Compare)

155 Borthwick Ave
Suite 200E
Portsmouth, NH 03801-7156
Phone (603) 436-1773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E9764ARMDOphthalmology Physician
24382MSMDOphthalmology Physician
54082TNMDOphthalmology Physician
R4518TXMDOphthalmology Physician
BP10047004TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Androscoggin Valley Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Androscoggin Valley Hospital Inc CurrentSince Oct 1, 2025 Accepting new patients
Kittery Ophthalmic Consultants Ophthalmology PastSince Aug 1, 2022 Accepting new patients

Locations

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1770840365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE STE 200E",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038014184",
            "telephone_number": "603-436-1773",
            "fax_number": "603-427-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE STE 200E",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038014184",
            "telephone_number": "603-436-1773",
            "fax_number": "603-427-0655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Ridge Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381209411",
            "country_code": "US",
            "telephone_number": "901-685-2200",
            "fax_number": "901-820-2342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Ridge Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381209411",
            "country_code": "US",
            "telephone_number": "901-685-2200",
            "fax_number": "901-820-2342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8300 Floyd Curl Dr Fl 6",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293931",
            "country_code": "US",
            "telephone_number": "210-450-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECK",
        "first_name": "KINLEY",
        "middle_name": "DANAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10047004",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "R4518",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "24382",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "E9764",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "54082",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AR",
            "license": "E9764",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MS",
            "license": "24382",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NH",
            "license": "19236",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "54082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214078001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376236101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3118506",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07208203",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "376236102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022120",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.