Individual provider Active NPI

Bruce S Beaulieu, DC

  • Chiropractor
  • Deerfield Beach, FL
National Provider Identifier
1164428181
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7902 Issued in FL
Practice address
910 NE 2ND St
Deerfield Beach, FL 33441-2138
Phone
(954) 570-7699
Fax
(954) 570-7698
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7902 FL Primary

Addresses

Primary practice location

910 NE 2ND St
Deerfield Beach, FL 33441-2138

Mailing address

910 NE 2ND St
Deerfield Beach, FL 33441-2138
Phone (954) 570-7699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050321000242 FL Practitioner - Chiropractic 8325093636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health and ChiropracticGroup PAC ID 7315992625, 2 clinicians

Practice addresses (Care Compare)

910 NE 2ND St
Deerfield Beach, FL 33441-2138
Phone (954) 570-7699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7902FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health and Chiropractic Medicine PA Chiropractor CurrentSince Aug 10, 2010 Accepting new patients

Locations

910 NE 2nd St
Deerfield Beach, FL 33441
Phone (561) 779-6039

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1164428181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 NE 2ND ST",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334412138",
            "telephone_number": "954-570-7699",
            "fax_number": "954-570-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 NE 2ND ST",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334412138",
            "telephone_number": "954-570-7699",
            "fax_number": "954-570-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "BRUCE",
        "middle_name": "S",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.