Individual provider Active NPI

Eduardo J. Colom Beauchamp, M.D.

  • Orthopaedic Surgery Physician
  • New York, NY
National Provider Identifier
1093020950
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
287773 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(212) 305-5974
NPI assigned
Aug 16, 2010
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 287773 NY
Orthopaedic Surgery Physician 207X00000X 287773 NY Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X 59106 MN

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

622 W 168TH St PH 11
New York, NY 10032-3720

Other practice location 1

200 University Ave E
Saint Paul, MN 55101-2507
Phone (651) 229-3990

Other practice location 2

200 University Ave E
Saint Paul, MN 55101-2507
Phone (651) 229-3990

Other practice location 3

200 University Ave E
Saint Paul, MN 55101
Phone (651) 229-3990

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ecolombeauchamp291459@excellian.direct.allina.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170802003494 NY Practitioner - Orthopedic Surgery 0143535518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Puerto Rico School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion42
Laminectomy or laminotomy (partial removal of spine bones)19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287773NYMDOrthopaedic Surgery Physician
59106MNMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Health Care CurrentSince Sep 12, 2016 Accepting new patients
Allina Health System Orthopaedic Surgery Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Aug 1, 2018 Accepting new patients
Childrens Health Care CurrentSince Sep 12, 2016 Accepting new patients
Childrens Health Care Current Accepting new patients
Allina Health System CurrentSince Aug 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Orthopaedic Surgery CurrentSince Jul 1, 2017 Accepting new patients
The Trustees of Columbia University in the City of New York Past Accepting new patients
NPI 1598824880 Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

2530 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

913 E 26th St
Ste 600
Minneapolis, MN 55404
Phone (612) 775-6257

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

200 University Ave E
Rm 10609
Saint Paul, MN 55101

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

3959 Broadway
Fl 8
New York, NY 10032
Phone (212) 305-1125

5141 Broadway
New York, NY 10034
Phone (212) 932-4000

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ph 11
New York, NY 10032
Phone (212) 305-4626

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ecolombeauchamp291459@excellian.direct.allina.com
  • Direct secure messaging: edb9038@direct.nyp.org
  • Direct secure messaging: eduardo.beauchamp.p1@direct.tcspine.nextgenshare.com
  • Direct secure messaging: eduardo.beauchamp.p2@direct.tcspine.nextgenshare.com

Organizations & group practices 11

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 6

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": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1093020950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST PH 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-5974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 University Ave E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012507",
            "country_code": "US",
            "telephone_number": "651-229-3990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 University Ave E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012507",
            "country_code": "US",
            "telephone_number": "651-229-3990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 University Ave E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "55101",
            "country_code": "US",
            "telephone_number": "651-229-3990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLOM BEAUCHAMP",
        "first_name": "EDUARDO",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-16",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NY",
            "license": "287773",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "287773",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MN",
            "license": "59106",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ecolombeauchamp291459@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "913 E 26th St Ste 600",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554044515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.