| Dr Bryan James Beardsley, MD | |
|
1207 Evergreen Ct, Clarkston, WA 99403-2874 | |
| (509) 769-2255 | |
| (509) 769-2255 |
| Full Name | Dr Bryan James Beardsley |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 26 Years |
| Location | 1207 Evergreen Ct, Clarkston, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104856087 | NPI | - | NPPES |
| 807636400 | Medicaid | ID | |
| 8169918 | Medicaid | WA | |
| 76800 | Other | ID | BLUECROSS OF IDAHO |
| 000010159447 | Other | ID | REGENCE BLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | M9722 (Idaho) | Primary |
| 207X00000X | Orthopaedic Surgery | MD00044939 (Washington) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Tri-state Memorial Hospital | Clarkston, WA | Hospital |
| St Marys Hospital And Clinics | Cottonwood, ID | Hospital |
| Syringa General Hospital | Grangeville, ID | Hospital |
| St Joseph Regional Medical Center | Lewiston, ID | Hospital |
| Wallowa Memorial Hospital | Enterprise, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tri-state Memorial Hospital | 4082502422 | 33 |
| Catalyst Medical Group Pllc | 2365722105 | 31 |
| Catalyst Medical Group Pllc | 2365722105 | 31 |
| Entity Name | Catalyst Medical Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912458787 PECOS PAC ID: 2365722105 Enrollment ID: O20161213001006 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Bryan James Beardsley, MD Po Box 189, Clarkston, WA 99403-0189 Ph: (509) 769-2254 | Dr Bryan James Beardsley, MD 1207 Evergreen Ct, Clarkston, WA 99403-2874 Ph: (509) 769-2255 |
Mr. Orie Eugene Kaltenbaugh, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 3565 Quailridge Dr, Clarkston, WA 99403 Phone: 208-746-5132 Fax: 208-746-0087 |