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Shad Beaty

Pediatrics • Normal, IL

Active NPI 1538241591 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

2005 Jacobssen Dr
Normal, IL 617616287

Call 3093197360 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2005 Jacobssen Dr

Normal, IL 617616287

Telephone 3093197360
Organization at the Same NPPES Address or Phone
Urohealth Institute, L.l.c. Facility NPI 1710020052

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Springfield Clinic, Llp. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

1999

Open Payments general payments, program year 2025

All general payments: $56.45 across 3 records.

By nature of payment

  • Food and Beverage: $56.45 across 3 records.

Reporting-company totals

  • Pfizer Inc.: $29.70 across 1 record.
  • Collegium Pharmaceutical, Inc.: $16.07 across 1 record.
  • Corium, LLC: $10.68 across 1 record.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

Years since graduation

27 years (graduated 1999)

CMS Doctors and Clinicians data list 1999 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Shad Beaty has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Shad Beaty as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Normal and Illinois

6 active clinicians are listed under Pediatrics with a practice address in Normal, IL (3,178 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments · Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $56.45.

Manufacturer Payment Nature Product Type Amount ($)
Pfizer Inc.
Food and Beverage
In-kind items and services
TRUMENBA General $29.70
Collegium Pharmaceutical, Inc.
Food and Beverage
Cash or cash equivalent
Jornay PM General $16.07
Corium, LLC
Food and Beverage
In-kind items and services
Azstarys General $10.68

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-10-03
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES IL 036-106215

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
036106215 (IL)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20130627000558

Enrollment State Jurisdiction

IL

PECOS Control ID

6103066998

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Springfield Clinic, Llp

775 Engineering Ave, Springfield, IL 627035909

Phone: 2175224300

Springfield Clinic, Llp

134 W Adams St, Morton, IL 615501802

Phone: 3092913380

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Sonia Gajula , MD

Internal Medicine - Endocrinology, Diabetes & Metabolism

NPI 1417055989

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
📍
Updated Practice Location October 03, 2022

Registered at 2005 JACOBSSEN DR, NORMAL, IL 617616287 (Tel: 3093197360)

📍
Updated Business Mailing Address October 03, 2022

Registered at PO BOX 19248, SPRINGFIELD, IL 627949248 (Tel: 2175287541)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2022

Pediatrics (license number reported to NPPES: IL 036-106215)

✅
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Practice Location (Initial Record) July 08, 2007

Registered at 435 MAXINE DR, MORTON, IL 615502498 (Tel: 3092632424)

📍
Business Mailing Address (Initial Record) July 08, 2007

Registered at 435 MAXINE DR, MORTON, IL 615502498 (Tel: 3092632424)

👤
Provider Name / Credentials (Initial Record) July 08, 2007

Recorded as SHAD BEATY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics

🟢
Initial NPI Registration & Enumeration October 19, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1538241591
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 19, 2006
Last Update: October 03, 2022
Sole Proprietor: No

Mailing Address

Po Box 19248

Springfield, IL 627949248

Phone: 2175287541

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.