Beaches Pediatrics, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BEACHES PEDIATRICS, PA

Practice address

13820 Old Saint Augustine Rd Ste 101
Jacksonville, FL 32258-5424

Phone

(904) 260-2565

NPI assigned

Nov 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jorge Rivera-Jimenez, M.D.NPI 1902978059

Title

President

Phone

(904) 246-8684

Specialties & licenses 2

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22574/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge Rivera-Jimenez, M.D.

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1902978059
  NPD Authorized official
• Erica Self Smith, APRN

  • Pediatric Nurse Practitioner
  • Jacksonville, FL
  • NPI 1518215805
  NPD (past)

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1295989606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13820 OLD SAINT AUGUSTINE RD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585424",
            "telephone_number": "904-260-2565",
            "fax_number": "904-246-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13820 OLD SAINT AUGUSTINE RD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585424",
            "telephone_number": "904-260-2565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 4th Ave N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322505621",
            "country_code": "US",
            "telephone_number": "904-246-8684",
            "fax_number": "904-246-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEACHES PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "RIVERA-JIMENEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-246-8684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018225000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Lashay Beach, CAPT / MC / USN
• Pamela Beach, APRN
• Kiara Beacham
• Beaches Behavioral Health LLC
• Beaches Behavioral, Inc.
• Beaches Pharmacy LLC
• Beaches Recovery Services LLC
• Beaches Urology PA
• Beacon Pediatric Behavioral Health
• Beacon Respiratory Services, Inc.

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.