Individual provider Active NPI

Donald P Beauchamp, M.D.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1114904661
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
228475-2 Issued in NY
Practice address
7400 18TH Ave
Brooklyn, NY 11204-5612
Phone
(718) 236-9446
Fax
(718) 236-3854
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 228475-2 NY Primary

Addresses

Primary practice location

7400 18TH Ave
Brooklyn, NY 11204-5612

Mailing address

7400 18TH Ave
Brooklyn, NY 11204-5612
Phone (718) 236-9446

Other identifiers 1

IdentifierTypeStateIssuer
2411549MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080104000509 NJ Practitioner - Family Practice 3971496563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228475-2NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Jul 1, 2016 Accepting new patients
Advanced Foot Care Associates PLLC Past Accepting new patients

Locations

85 Harristown Rd
Ste 200
Glen Rock, NJ 07452
Phone (201) 444-4526

301 Godwin Ave
Midland Park, NJ 07432
Phone (201) 444-4526

1 Valley Health Plz
Paramus, NJ 07652
Phone (201) 634-5353

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Interoperability endpoints

  • Direct secure messaging: donald.beauchamp.2@5622.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114904661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045612",
            "telephone_number": "718-236-9446",
            "fax_number": "718-236-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045612",
            "telephone_number": "718-236-9446",
            "fax_number": "718-236-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "DONALD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "228475-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2411549",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.