SHAD BEATY – Pediatrics Physician, NPI 1538241591

SHAD BEATY is a healthcare provider. based in Springfield, Illinois. specializing in PEDIATRIC MEDICINE. They hold a License No. 036-106215 (IL). The NPI Number for SHAD BEATY is 1538241591

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
SHAD BEATY
NPI
1538241591
Phone
(217) 528-7541
Address
PO BOX 19248
Enumeration Date
19 October 2006
Last Update Date
3 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3092913380
Graduation Year
1999 (27 years ago)
PAC ID
6103066998
Group Practice PAC ID
0547166076
Professional Enrollment ID
I20130627000558
Address ID
IL615501802MO134XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,158 PEDIATRIC MEDICINE in IL

Provider Addresses for SHAD BEATY

  • PO BOX 19248

    SPRINGFIELD, IL 627949248

    Phone: (217) 528-7541

    Type: Mailing

  • 2005 JACOBSSEN DR

    NORMAL, IL 617616287

    Phone: (309) 319-7360

    Type: Location

  • Maxine Drive, Morton, Tazewell County, Illinois, 61550, United States

    MORTON, IL 615502498

    Phone: (309) 263-2424

    Fax: (309) 284-2255

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $336.

Total Amount is formed as General ($336) + Research ($0) + Ownership ($0) = $336.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Novo Nordisk Inc ($45).

Total Amount

$336

General + Research + Ownership

Payments

16

Total payment records

General Amount

$336

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2013-06-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130627000558IPediatric MedicineILTBD

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.

Verify on CMS Revalidation Lookup Tool

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 62794)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547166076View full group profile

Reviews

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Frequently asked questions

Where can patients find SHAD BEATY's NPI?
You can confirm SHAD BEATY with NPI 1538241591; it appears in the national provider directory.
Does this profile mean SHAD BEATY is currently active?
Yes — SHAD BEATY appears active in the national provider directory.
What kind of provider is SHAD BEATY?
The page reflects Pediatrics Physician for SHAD BEATY. Clinical services aligned with this taxonomy classification.
What location shows for SHAD BEATY?
We surface Springfield, Illinois for SHAD BEATY based on available NPPES addresses.
Is SHAD BEATY a real provider?
This page reflects official NPPES data for NPI 1538241591. Always confirm identity and privileges with the practice and licensing boards.

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