SHAD BEATY – Pediatrics Physician, NPI 1538241591
Pediatrics Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $45 |
| PFIZER INC. | $33 |
| SANOFI-AVENTIS U.S. LLC | $28 |
| Axonics, Inc. | $28 |
| SANOFI PASTEUR INC. | $25 |
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130627000558 | I | Pediatric Medicine | IL | 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 62794)
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Group practice members
- 1
- 2
- 3
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| - | IL | |
| - | IL | |
| Internal Medicine | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Diagnostic Radiology | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | IL |
Reviews
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