DR. KATHERINE ANN BEAUDRY (M.D.) – Dermatology Physician, NPI 1659667954

DR. KATHERINE ANN BEAUDRY (M.D.) is a healthcare provider. based in Peoria, Illinois. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. 036136919 (IL). The NPI Number for DR. KATHERINE ANN BEAUDRY (M.D.) is 1659667954

Main info

Female
Sole Proprietor
15 Years Of Experience
Name
DR. KATHERINE ANN BEAUDRY (M.D.)
NPI
1659667954
Phone
(309) 691-2903
Address
5401 N KNOXVILLE AVE STE 115
Enumeration Date
24 June 2011
Last Update Date
8 April 2020

Doctor Profile

Medical School Name
PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
3096912903
Graduation Year
2011 (15 years ago)
PAC ID
3375789134
Group Practice PAC ID
2860463510
Professional Enrollment ID
I20150602002891
Address ID
IL616145068PE5401XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

703 DERMATOLOGY in IL

Provider Addresses for DR. KATHERINE ANN BEAUDRY (M.D.)

  • 5401 N KNOXVILLE AVE STE 115

    PEORIA, IL 616145095

    Phone: (309) 691-2903

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 48 Open Payments records for all available years, with a total value of $1,021.

Total Amount is formed as General ($1,021) + Research ($0) + Ownership ($0) = $1,021.

Last reported payment date: 2024-11-11 • Largest payer in this snapshot: ABBVIE INC. ($226).

Total Amount

$1,021

General + Research + Ownership

Payments

48

Total payment records

General Amount

$1,021

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-11

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: 2015-06-02

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
I20150602002891IDermatologyILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths2,820369$0
99213Established patient office or other outpatient visit, 20-29 minutes840663$0
17000Destruction of precancer skin growth, 1 growth627470$0
11102Biopsy of related skin growth, first growth295268$0
17110Destruction of skin growth, 1-14 growths277237$0
View full utilization report →

Insurance plans in this area (ZIP 61614)

Loading plans...

Provider's Procedures

DR. KATHERINE ANN BEAUDRY (M.D.) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYTN11101Biopsy of each additional growth of skin and/or tissue4229
DERMATOLOGYTN17003Destruction of 2-14 skin growths841111

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: 2860463510View full group profile
NameSpecialtyState
D E R M A T O L O G YIL
D E R M A T O L O G YIL
D E R M A T O L O G YIL
Physician AssistantIL

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do payers reference DR. KATHERINE ANN BEAUDRY (M.D.)?
For DR. KATHERINE ANN BEAUDRY (M.D.), use NPI 1659667954 as the unique 10-digit identifier.
Active or inactive — what applies to DR. KATHERINE ANN BEAUDRY (M.D.)?
You should see DR. KATHERINE ANN BEAUDRY (M.D.) as active in CMS-hosted NPPES data.
How would a patient describe DR. KATHERINE ANN BEAUDRY (M.D.)'s focus?
For DR. KATHERINE ANN BEAUDRY (M.D.), the primary taxonomy reads as Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is DR. KATHERINE ANN BEAUDRY (M.D.) registered?
Use Peoria, Illinois as the headline location for DR. KATHERINE ANN BEAUDRY (M.D.) here.
Does DR. KATHERINE ANN BEAUDRY (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

Similar Providers

DR. JEFFREY K MCKENNA (MD)

MOHS-Micrographic Surgery Physician
3024 E Empire St Ste Eandf
NPI: 1396713780

DR. CARL WILLIAM JR. SODERSTROM (M.D.)

Dermatopathology Physician
4909, North Glen Park Pl Road, Peoria, Peoria County, Illinois, 61614, United States
NPI: 1053370759
North Glen Park Place Road, Peoria, Peoria County, Illinois, 61614, United States
NPI: 1710931670
North Glen Park Place Road, Peoria, Peoria County, Illinois, 61614, United States
NPI: 1912017245

HARRY C STONE (M.D.)

Dermatology Physician
5401 N KNOXVILLE AVE STE 115
NPI: 1538250220

CHRISTOPHER T KROODSMA (M.D.)

Dermatology Physician
5401 N KNOXVILLE AVE STE 115
NPI: 1336230051

BRUCE A MCLELLAND (M.D.)

Dermatology Physician
5401 N KNOXVILLE AVE STE 115
NPI: 1689762189
5401, North Knoxville Avenue, Peoria, Peoria County, Illinois, 61614, United States
NPI: 1548358054

DR. MERINER M PEREIRA (M.D.)

Dermatology Physician
2315 Roosevelt St
NPI: 1639226731