DR. JOHN P BEAVERS (NP) – Nurse Practitioner, NPI 1003066143
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. JOHN P BEAVERS (NP)
5717, Oakland Drive, Portage, Kalamazoo County, Michigan, 49024, United States
PORTAGE, MI 490241116
Phone: (269) 323-4473
Fax: (517) 278-2784
Type: Mailing
1514 JEFFERSON HWY
NEW ORLEANS, LA 701212483
Phone: (504) 842-3000
Type: Mailing
1401 JEFFERSON HWY
NEW ORLEANS, LA 701212426
Phone: (504) 842-4747
Type: Location
1401 Roosevelt Ave
York, PA 174042244
Phone: (717) 851-1405
Type: Location
30 Maryland Plz
Saint Louis, MO 631081556
Phone: (314) 720-5858
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: 2024-12-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20081213000098 | I | Nurse Practitioner | MI | TBD |
| I20231010003147 | I | Nurse Practitioner | MD | TBD |
| I20231121002618 | I | Nurse Practitioner | MN | TBD |
| I20241003000385 | I | Nurse Practitioner | NC | TBD |
| I20241213000676 | I | Nurse Practitioner | LA | 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 49024)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI | |
| Nurse Practitioner | IN | |
| - | MI | |
| Internal Medicine | MI | |
| Preventive Medicine, Family Practice | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| - | MI |
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