Maximillian Gustav Beushausen, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30.024294 Issued in OH

Practice address

4774 Munson St NW
Suite 102
Canton, OH 44718-3634

Phone

(330) 494-6653

Fax

(330) 494-6630

NPI assigned

May 21, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Ohios Center for Ofandi Surgery IncGroup PAC ID 5496983918, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: mbeushausen569764@ehrdirect.uhhospitals.org

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.

• Ohios Center for of&I Surgery Inc

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Mentor, OH
  • NPI 1497181036
  Medicare reassignment Care Compare group
• Dietrich & Associates Oral and Maxillofacial Surgery, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Canton, OH
  • NPI 1528153533
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• The Metrohealth System

  dba Metrohealth Professional Group

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1053353896
  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1770929408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4774 MUNSON ST NW",
            "address_2": "SUITE 102",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183634",
            "telephone_number": "330-494-6653",
            "fax_number": "330-494-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4774 MUNSON ST NW",
            "address_2": "SUITE 102",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183634",
            "telephone_number": "330-494-6653",
            "fax_number": "330-494-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEUSHAUSEN",
        "first_name": "MAXIMILLIAN",
        "middle_name": "GUSTAV",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30.024294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wendy M Bettes, SWA
• Elaina Marie Bettura, PHARMD
• Nicole Lee Betz, LPN
• Danielle Beyes, DO
• Brian J Beyman, RPH
• Beyond Our Boundaries, LLC
• Pramod Anand Bhargava, M.D.
• Viraj Bhatt, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Canton, OH
• Providers in Canton, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.