Individual provider Active NPI

Kevin Richard Beach, M.D.

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1144434614
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
TRN11389 Issued in FL
Practice address
1 Davis Blvd
Suite 504
Tampa, FL 33606-3463
Phone
(813) 627-5931
NPI assigned
May 10, 2007
Last updated
Jan 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TRN11389 FL Primary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X MT185033 PA

Addresses

Primary practice location

1 Davis Blvd
Suite 504
Tampa, FL 33606-3463

Mailing address

113 S Melville Ave Apt 4
Tampa, FL 33606-1861
Phone (410) 804-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100619000034 FL Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 2769512607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN11389FLMDEmergency Medicine Physician
MT185033PAMDPediatric Hospice and Palliative Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Emergency Physicians Inc Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Oakfield Drive Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1144434614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S MELVILLE AVE APT 4",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061861",
            "telephone_number": "410-804-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DAVIS BLVD",
            "address_2": "SUITE 504",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063463",
            "telephone_number": "813-627-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "KEVIN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "TRN11389",
            "primary": true
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "PA",
            "license": "MT185033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.