NPIMap

Individual provider Active NPI

Esira Jaimie Beaubrun, MD

  • Internal Medicine Physician
  • Bloomfield, NJ
National Provider Identifier
1013276062
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA09780500 Issued in NJ
Practice address
323 Belleville Ave FL 2
Bloomfield, NJ 07003-3648
Phone
(973) 842-4272
Fax
(732) 997-3022
NPI assigned
May 11, 2012
Last updated
Nov 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 25MA09780500 NJ
Internal Medicine Physician 207R00000X 25MA09780500 NJ Primary

Addresses

Primary practice location

323 Belleville Ave FL 2
Bloomfield, NJ 07003-3648

Mailing address

323 Belleville Ave FL 2
Bloomfield, NJ 07003-3648
Phone (973) 842-4272

Other identifiers 1

IdentifierTypeStateIssuer
0532584MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000197 NJ Practitioner - Internal Medicine 3375843154 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
People Care InstituteGroup PAC ID 4880965813, 2 clinicians

Practice addresses (Care Compare)

796 Northfield Ave
West Orange, NJ 07052-1025
Phone (973) 842-4272

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09780500NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eoh Acquisition Group, LLC CurrentSince Jan 1, 2022 Accepting new patients
People Care Institute CurrentSince Nov 1, 2017 Accepting new patients
Pathology Associates, PC Current Accepting new patients
Eoh Acquisition Group, LLC CurrentSince Jan 1, 2022 Accepting new patients
Clara Maass Medical Center Past Accepting new patients

Locations

323 Belleville Ave
Fl 2
Bloomfield, NJ 07003
Phone (973) 842-4272

240 Central Ave
East Orange, NJ 07018
Phone (973) 414-3473

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

796 Northfield Ave
West Orange, NJ 07052
Phone (973) 736-7647

Interoperability endpoints

  • Direct secure messaging: ebeaubrun229643@epicdirect.rwjbh.org
  • Direct secure messaging: esirabeaubrun@pci-nj.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1013276062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 BELLEVILLE AVE FL 2",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033648",
            "telephone_number": "973-842-4272",
            "fax_number": "732-997-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 BELLEVILLE AVE FL 2",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033648",
            "telephone_number": "973-842-4272",
            "fax_number": "732-997-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUBRUN",
        "first_name": "ESIRA",
        "middle_name": "JAIMIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "25MA09780500",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09780500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0532584",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.