Individual provider Active NPI

Jerold Edmond Beeve, MD

  • Ophthalmology Physician
  • Glendale, CA
National Provider Identifier
1306929393
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G018274 Issued in CA
Practice address
1809 Verdugo Blvd
Suite 150
Glendale, CA 91208-1416
Phone
(818) 790-8001
Fax
(818) 790-7757
NPI assigned
Oct 23, 2006
Last updated
Apr 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G018274 CA Primary

Addresses

Primary practice location

1809 Verdugo Blvd
Suite 150
Glendale, CA 91208-1416

Mailing address

1809 Verdugo Blvd
Suite 150
Glendale, CA 91208-1416
Phone (818) 790-8001

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120131000601 CA Practitioner - Ophthalmology 6406833730 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18274CAMDAcupuncturist
G018274CAMDOphthalmology Physician

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, 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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1306929393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 VERDUGO BLVD",
            "address_2": "SUITE 150",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081416",
            "telephone_number": "818-790-8001",
            "fax_number": "818-790-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 VERDUGO BLVD",
            "address_2": "SUITE 150",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081416",
            "telephone_number": "818-790-8001",
            "fax_number": "818-790-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEVE",
        "first_name": "JEROLD",
        "middle_name": "EDMOND",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G018274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.