Individual provider Active NPI

Sandra Katarina Bon-Beam, DC

  • Chiropractor
  • Freehold, NJ
National Provider Identifier
1376688101
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00475200 Issued in NJ
Practice address
55 Schanck Rd
Ste B-19
Freehold, NJ 07728-3067
Phone
(732) 294-0004
Fax
(732) 294-0438
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00475200 NJ Primary

Addresses

Primary practice location

55 Schanck Rd
Ste B-19
Freehold, NJ 07728-3067

Mailing address

602 Candlewood CMNS
Howell, NJ 07731-2173
Phone (732) 901-3001

Other identifiers 1

IdentifierTypeStateIssuer
6701302MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110805000249 NJ Practitioner - Chiropractic 3173792249 Reassigns benefits to 1 organization
Practice locations: Freehold, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beam Chiropractic Health CenterGroup PAC ID 9537469473, 4 clinicians

Practice addresses (Care Compare)

602 Candlewood CMNS
Howell, NJ 07731-2173
Phone (732) 901-3001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beam Chiropractic Health Center Chiropractor CurrentSince Jun 7, 2015 Accepting new patients

Locations

55 Schanck Rd
Ste B19
Freehold, NJ 07728
Phone (732) 294-0004

602 Candlewood Cmns
Howell, NJ 07731
Phone (732) 901-3001

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1376688101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 CANDLEWOOD CMNS",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077312173",
            "telephone_number": "732-901-3001",
            "fax_number": "732-901-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SCHANCK RD",
            "address_2": "STE B-19",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283067",
            "telephone_number": "732-294-0004",
            "fax_number": "732-294-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BON-BEAM",
        "first_name": "SANDRA",
        "middle_name": "KATARINA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00475200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6701302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.