Mary Eleanor Beal, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

4301050919 Issued in MI

Practice address

3837 W. Front St
Suite H
Traverse City, MI 49684

Phone

(231) 935-8878

Fax

(231) 935-8901

NPI assigned

Oct 3, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Physician'S Weight Management Center

  • Addiction Medicine (Internal Medicine) Physician
  • Traverse City, MI
  • NPI 1295870384
  NPD (past) Authorized official
• Poplar Bluff Regional Medical Center LLC

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724
  NPD (past)
• SSM Health Care St. Louis

  • Emergency Medical Services (Emergency Medicine) Physician
  • Lake St Louis, MO
  • NPI 1538113097
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1982798583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3837 W FRONT ST",
            "address_2": "STE H",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846024",
            "telephone_number": "231-935-8878",
            "fax_number": "231-935-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3837 W. FRONT ST",
            "address_2": "SUITE H",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-8878",
            "fax_number": "231-935-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAL",
        "first_name": "MARY",
        "middle_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301050919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "1102810071",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4980484",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bayside Wellness, LLC
• Bayside Wellness, LLC
• Kathryn M Bazzett, AU.D.
• BDD of Michigan P.C.
• Kerie Marcella Beadleston
• Bradley Beaman, PHARMD
• Victoria Lynn Bean, RN
• Kimberly Leeann Beard
• Caitlin Bearss
• Ciera Beattie

• Endocrinology, Diabetes & Metabolism Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.