Joshua Beausoleil, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101000545 Issued in MI

Practice address

790 Letica Dr
Rochester, MI 48307-1581

Phone

(248) 841-8754

NPI assigned

May 23, 2021

Sex

Male

Sole proprietor

Yes

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

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366

  MI, Speech-Language Pathologist

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Speech-Language Pathologist

  NPD

Specialty

Qualified Speech Language Pathologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLC 600 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 23, 2021.

{
    "created_epoch": "1621728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621728000000",
    "number": "1104491190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 NORMANDY RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736366",
            "telephone_number": "313-520-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 LETICA DR",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071581",
            "telephone_number": "248-841-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUSOLEIL",
        "first_name": "JOSHUA",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-23",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Elizabeth Barrett, M.D.
• Samantha Nicole Barrow, PA
• Bartol Biocic M.D. PC
• Mykeya Bartow
• David Bauer, M.D.
• Richard Beck
• David L Becker, CRNA
• Karen Becker, BSN, RN
• Nicholas Belair
• Donald Bell

• All providers in Rochester, MI
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.