DR. RODERICK WILLIAM BEAVER (MD) – Emergency Medicine Physician, NPI 1689615692
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,209 EMERGENCY MEDICINE in WA
Provider Addresses for DR. RODERICK WILLIAM BEAVER (MD)
PO BOX 101519
PASADENA, CA 911890009
Phone: (626) 447-0296
Type: Mailing
211 NE Skyline Dr
White Salmon, WA 986721948
Phone: (509) 493-1101
Type: Location
PeaceHealth St. John Medical Center, 1615, Delaware Street, Longview, Cowlitz County, Washington, 98632, United States
LONGVIEW, WA 986322367
Phone: (360) 414-2000
Type: Location
34400 NE LESTER AVE
LA CENTER, WA 986293413
Phone: (360) 448-0587
Fax: (360) 263-4928
Type: Mailing
174 1ST AVE N
ILWACO, WA 986249137
Phone: (360) 448-0587
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2006-04-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060418000189 | I | Emergency Medicine | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91189)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA | |
| Nurse Practitioner | NMI | |
| - | WA | |
| Family Practice | WA | |
| Osteopathic Manipulative Medicine | MI | |
| - | WA | |
| Physician Assistant | OR | |
| Nurse Practitioner | NV | |
| Clinical Social Worker | WA | |
| Nurse Practitioner | CA |
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