Individual provider Active NPI

Breanna Giachinta, PA-C

  • Physician Assistant
  • Beaufort, SC
National Provider Identifier
1205498300
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1055 Ribaut Rd Ste 30
Beaufort, SC 29902-5447
Phone
(843) 476-4702
NPI assigned
Jun 28, 2019
Last updated
Jun 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1055 Ribaut Rd Ste 30
Beaufort, SC 29902-5447

Mailing address

37 Savannah LN
Richmond Hill, GA 31324-7630
Phone (201) 414-7297

Other practice location 1

16 Okatie Ctr Blvd
Bluffton, SC 29909-7533
Phone (843) 476-4702

Other names 1

  • Breanna Newsome Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200630000302 GA Practitioner - Physician Assistant 5294161998 Reassigns benefits to 1 organization
I20220322000534 FL Practitioner - Physician Assistant 5294161998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vijapura Behavioral Health PLLCGroup PAC ID 1658667597, 6 clinicians

Practice addresses (Care Compare)

9141 Cypress Green Dr
Suite 1
Jacksonville, FL 32256-2006
Phone (904) 733-7333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3282SCMDNurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1205498300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 SAVANNAH LN",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313247630",
            "telephone_number": "201-414-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 RIBAUT RD STE 30",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025447",
            "telephone_number": "843-476-4702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Okatie Ctr Blvd",
            "address_purpose": "LOCATION",
            "city": "Bluffton",
            "state": "SC",
            "postal_code": "299097533",
            "country_code": "US",
            "telephone_number": "843-476-4702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIACHINTA",
        "first_name": "BREANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNA",
            "last_name": "NEWSOME",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.