Active NPI
Megen Q Bejvan, PT
- Physical Therapist
- Appleton, WI
National Provider Identifier
1780237826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14372
- Practice address
- 2500 E Capitol Dr
Appleton, WI 54911-8735 - Phone
- (920) 831-5050
- NPI assigned
- Jul 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05013138A | IN | |
| Physical Therapist | 225100000X | 14372 | WI | Primary |
Addresses
Primary practice location
2500 E Capitol Dr
Appleton, WI 54911-8735
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 831-5050
Other practice location 1
3221 Beacon Pkwy Ste 100
Granger, IN 46530-7196
Phone (574) 647-2930
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300028434 | Medicaid | IN | |
| IN3678024 | Other | IN | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05013138A | IN | MD | Physical Therapist |
| 14372 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Health, LLC | Past | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Interoperability endpoints
- mbejvan323740@direct.thedacare.org
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1780237826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 NEENAH CTR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549563070",
"telephone_number": "920-831-5050",
"fax_number": "920-735-7648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 E CAPITOL DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549118735",
"telephone_number": "920-831-5050"
}
],
"practiceLocations": [
{
"address_1": "3221 Beacon Pkwy Ste 100",
"address_purpose": "LOCATION",
"city": "Granger",
"state": "IN",
"postal_code": "465307196",
"country_code": "US",
"telephone_number": "574-647-2930",
"fax_number": "574-647-2935",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BEJVAN",
"first_name": "MEGEN",
"middle_name": "Q",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-18",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05013138A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14372",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300028434",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "IN3678024",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.