NPIMap

Individual provider Active NPI

Stephen Beaudoin, M.D.

  • Internal Medicine Physician
  • Newburyport, MA
National Provider Identifier
1902808124
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
70450 Issued in MA
Practice address
260 Merrimac St
Newburyport, MA 01950-2192
Phone
(978) 499-7200
Fax
(978) 499-7216
NPI assigned
Jun 1, 2005
Last updated
May 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 70450 MA Primary

Addresses

Primary practice location

260 Merrimac St
Newburyport, MA 01950-2192

Mailing address

260 Merrimac St
Newburyport, MA 01950-2192
Phone (978) 499-7200

Other identifiers 13

IdentifierTypeStateIssuer
110049133AMedicaidMA
5305442OtherAETNA - NON-HMO
070450OtherMATUFTS HEALTH PLAN
110214704OtherRAILROAD MEDICARE
J10622OtherMABLUE CROSS BLUE SHIELD
2876947OtherCIGNA
73374OtherHEALTHSOURCE
30005433OtherNHNEW HAMPSHIRE MEDICAID
1902808124OtherAETNA - HMO
E71908OtherNHANTHEM BLUE CROSS
60722OtherMAHARVARD PILGRIM HEALTHCAR
04-08373OtherEVERCARE
974551OtherNETWORK HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411000970 MA Practitioner - Internal Medicine 5890740641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

1 Park Way
Haverhill, MA 01830-6278
Phone (978) 521-3230

260 Merrimac St
Newburyport, MA 01950-2192
Phone (978) 499-7200

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince Jul 1, 2015 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Pentucket Medical Associates, LLC Internal Medicine Current Accepting new patients
Mass General Brigham Community Physicians Inc. Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
River Valley Infectious Disease Specialists Inc. Past Accepting new patients
Northeast Radiology Associates, LLP Past Accepting new patients
Seacoast Affiliated Group Practice, Inc. Past Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

66 E Main St
Georgetown, MA 01833
Phone (978) 352-7780

1 Parkway
Haverhill, MA 01830
Phone (978) 521-3210

360 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

260 Merrimac St
Newburyport, MA 01950
Phone (978) 499-7200

260 Merrimac St
Ofc
Newburyport, MA 01950
Phone (978) 463-2065

Interoperability endpoints

  • Direct secure messaging: beaudoin.stephen.pma@direct.partners.masshiway.net

Organizations & group practices 8

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1902808124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MERRIMAC ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502192",
            "telephone_number": "978-499-7200",
            "fax_number": "978-499-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MERRIMAC ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502192",
            "telephone_number": "978-499-7200",
            "fax_number": "978-499-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "70450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110049133A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - NON-HMO",
            "identifier": "5305442",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "070450",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110214704",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J10622",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2876947",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "73374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW HAMPSHIRE MEDICAID",
            "identifier": "30005433",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "1902808124",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "E71908",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "60722",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "04-08373",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "974551",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

Verify at the official NPI Registry.