Matthew Beaudoin

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4315 Issued in CT

Practice address

222 Aldbourne Dr
Bristol, CT 06010-2396

Phone

(860) 985-8248

NPI assigned

Oct 21, 2014

Last updated

Oct 21, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crossroads Physical Therapy LLCGroup PAC ID 7214196971, 11 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crossroads Physical Therapy LLC

  • Physical Therapist
  • Columbia, CT
  • NPI 1134295678
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1982008801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 ALDBOURNE DR",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ALDBOURNE DR",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102396",
            "telephone_number": "860-985-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "4315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thaddeus W Bartles, O.D.
• Kelli Bastiaanse
• Matthew J Bastiaanse, LMFT
• Nicole Baumgartner
• Rona Christine Bayacal
• Becky Kreuzer Aprn, Pmhnp, LLC
• Nadeem S Behjet, M.D.
• Kaylie Nicole Behuniak, PA
• Olivia June Bell-Brantley, LPCA
• Peter Bellezza

• Occupational Therapist in Bristol, CT
• Providers in Bristol, CT by specialty
• Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.