Jackelyn Tanios Beshir, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A156540 Issued in CA

Practice address

2001 Santa Monica Blvd Ste 1070
Santa Monica, CA 90404-2202

Phone

(310) 917-3376

Fax

(310) 582-6302

NPI assigned

Jun 2, 2014

Last updated

Sep 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Dermatology

Education

Rush Medical College of Rush University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Dermatology of Long Beach PCGroup PAC ID 6002076528, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbeshir673275@direct.uclahealth.org
• Direct secure messaging: jbeshir784209@direct.memorialcare.org

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.

• Comprehensive Dermatology of Long Beach PC

  • Dermatology Physician
  • Long Beach, CA
  • NPI 1720356827
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1174935670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 1070",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042202",
            "telephone_number": "310-917-3376",
            "fax_number": "310-582-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESHIR",
        "first_name": "JACKELYN",
        "middle_name": "TANIOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A156540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Taylor Bernthal, MD
• Caitlin E Berry, D.P.T.
• Ronald James Berry, P.T.
• Teresa Ann Bertoncin, LMFT, LPCC
• Jacob Berumen, NP
• Samantha Robyn Haas Besser, DMD
• Best Natural Smile
• Best Physical Therapy & Sports Medicine, Inc
• Beth Siegler, a Medical Corporation
• John S Bettinger, DDS

• Dermatology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.

Verify at the official NPI Registry.