Active NPI
John E Beaulieu, M.D.
- Internal Medicine Physician
- Swampscott, MA
National Provider Identifier
1124068663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 60663
- Practice address
- 990 Paradise Rd
Suite 2F
Swampscott, MA 01907-1395 - Phone
- (781) 599-7802
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 60663 | MA | Primary |
Addresses
Primary practice location
990 Paradise Rd
Suite 2F
Swampscott, MA 01907-1395
Mailing address
990 Paradise Rd
Suite 2F
Swampscott, MA 01907-1395
Phone (781) 599-7802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3049647 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080418000048 | MA | Practitioner - Internal Medicine | 1153409016 | Practice locations: Swampscott, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Massachusetts Medical School, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
990 Paradise Rd
2F
Swampscott, MA 01907-1309
Phone (781) 599-7802
Hospital & facility affiliations
- Mass General Brigham Home Care, Inc
- All Care Vna-Greater Lynn Inc
- Care Dimensions, Inc
- North Shore Medical Center -
- Lahey Hospital & Medical Center, Burlington
- Massachusetts General Hospital
- Brigham and Women'S Hospital
- Spaulding Rehabilitation Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Lynn, MA
- NPI 1386640597
-
- Home Health Agency
- Newton, MA
- NPI 1083644017
-
- Rehabilitation Hospital
- Charlestown, MA
- NPI 1780600825
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414972800000",
"number": "1124068663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 PARADISE RD",
"address_2": "SUITE 2F",
"city": "SWAMPSCOTT",
"state": "MA",
"postal_code": "019071395",
"telephone_number": "781-599-7802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 PARADISE RD",
"address_2": "SUITE 2F",
"city": "SWAMPSCOTT",
"state": "MA",
"postal_code": "019071395",
"telephone_number": "781-599-7802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAULIEU",
"first_name": "JOHN",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2014-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "60663",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3049647",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Swampscott, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.