Individual provider Active NPI

Angela Beams, PA-C

  • Medical Physician Assistant
  • Vineland, NJ
National Provider Identifier
1073508826
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00529200 Issued in NJ
Practice address
301 S Main Rd
Vineland, NJ 08360-7897
Phone
(856) 692-0502
Fax
(856) 691-1710
NPI assigned
Sep 19, 2005
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00529200 NJ Primary
Medical Physician Assistant 363AM0700X PA3146 FL

Addresses

Primary practice location

301 S Main Rd
Vineland, NJ 08360-7897

Mailing address

301 S Main Rd
Vineland, NJ 08360-7897
Phone (856) 692-0502

Other identifiers 1

IdentifierTypeStateIssuer
970022448OtherFLMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816000364 NJ Practitioner - Physician Assistant 4880767516 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3146FLMDMedical Physician Assistant
25MP00529200NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
W Peter Graper MD PA Past Accepting new patients
Ambulatory Care Physicians of Sarasota LLC Past Accepting new patients
Thomas F. Kelly, MD, PA Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1073508826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S MAIN RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607897",
            "telephone_number": "856-692-0502",
            "fax_number": "856-691-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MAIN RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607897",
            "telephone_number": "856-692-0502",
            "fax_number": "856-691-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAMS",
        "first_name": "ANGELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00529200",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA3146",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "970022448",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.