Individual provider Active NPI

Robert J Beyer, RPA-C

  • Medical Physician Assistant
  • Latham, NY
National Provider Identifier
1093965683
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002019 Issued in NY
Practice address
776A Watervliet Shaker Rd
Latham, NY 12110-2209
Phone
(800) 732-8004
NPI assigned
Sep 19, 2008
Last updated
Sep 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002019 NY Primary

Addresses

Primary practice location

776A Watervliet Shaker Rd
Latham, NY 12110-2209

Mailing address

776A Watervliet Shaker Rd
Latham, NY 12110-2209
Phone (800) 732-8004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002019NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1093965683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776A WATERVLIET SHAKER RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102209",
            "telephone_number": "800-732-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776A WATERVLIET SHAKER RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102209",
            "telephone_number": "800-732-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYER",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "002019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.