Michael Beaudoin, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTO12778L Issued in PA

Practice address

2127 Rhawn St
Philadelphia, PA 19152-3216

Phone

(215) 742-8099

Fax

(215) 742-1871

NPI assigned

Jan 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical TherapyGroup PAC ID 9335397488, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Physical Therapy

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1689784217
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1861472078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523216",
            "telephone_number": "215-742-8099",
            "fax_number": "215-742-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523216",
            "telephone_number": "215-742-8099",
            "fax_number": "215-742-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PTO12778L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PC",
            "identifier": "1726303",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "45798",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMIN",
            "identifier": "Q87414",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1687414",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "50711",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2395652000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "610675900",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2395652000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3839602",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE 65",
            "identifier": "2395652000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "2395652000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ PLUS",
            "identifier": "246902",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30023534",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Beatty, MD
• Maria Legaspi Beatty, MA, LPC
• Briana Beaty
• Carolyn W Beauchamp, PA-C
• Francis-Olivier Beauchamp, MD
• Scott Beaudoin
• Forrest Paul Beaulieu, MD
• Eliane Beauregard-Lacroix, MD
• David Beausang, M.D.
• Beaute Within Medical Wig Company

• Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.