Jason S Beales, MD
Individual provider Active NPI Pediatrics Physician · Roosevelt, UT
NPI 1891755872 · NPPES record last updated May 2, 2017
Key facts
- NPI
- 1891755872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 53066341205 (UT)
- Practice address
- 210 W 300 N 75-3
Roosevelt, UT 84066 - Phone
- (435) 722-3971
- Fax
- (435) 722-6104
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100505000841 | UT | Practitioner - Pediatric Medicine | 2769510171 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53066341205 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uintah Basin Medical Center | Current |
Accepting new patients | |
| Northeastern Utah Medical Group | Pediatrics | Current |
Accepting new patients |
| Northeastern Utah Medical Group | Current |
Accepting new patients | |
| Uintah Basin Medical Center | Current |
Accepting new patients |
Locations
50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426
250 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691
250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691
210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691
210 W 300 N
#753
Roosevelt, UT 84066
Phone (435) 722-3971
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 53066341205 | UT | Yes |
Addresses
Primary practice location
210 W 300 N 75-3
Roosevelt, UT 84066
Mailing address
210 W 300 N 75-3
Roosevelt, UT 84066
Phone (435) 722-3971
Other providers in Roosevelt, UT
- Basin Family Pharmacy
- Basin Therapy LLC
- Vail Shanae Batty
- Kerry Robert Baum Jr.
- Garrison Douglas Beach
- Trent Bell
- Patricia S Bennett
- Megan D'on Berlin
- Beverly Berrett
- Samuel Mark Bertoch
All providers in Roosevelt, UT · Pediatrics Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.