Individual provider Active NPI

Charles Edward Beaulieu, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1780654954
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
29781 Issued in AZ
Practice address
1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633
Phone
(602) 744-4765
Fax
(602) 744-4799
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 29781 AZ Primary

Addresses

Primary practice location

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633

Mailing address

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633
Phone (602) 744-4765

Other identifiers 2

IdentifierTypeStateIssuer
743030MedicaidAZ
050090896OtherMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100929000701 AZ Practitioner - Anesthesiology 2264558014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Georgetown University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners of Arizona LLCGroup PAC ID 8628317179, 85 clinicians

Practice addresses (Care Compare)

4605 E Elwood St
Suite 500
Phoenix, AZ 85040-1978
Phone (602) 200-9021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29781AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners of Arizona LLC Anesthesiology CurrentSince May 1, 2021 Accepting new patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Nov 18, 2002 Accepting new patients

Locations

501 N Switzer Canyon Dr
Flagstaff, AZ 86001
Phone (928) 440-4610

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

750 N 40th St
Phoenix, AZ 85008
Phone (602) 797-7700

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1780654954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "29781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "743030",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "050090896",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.