Individual provider Active NPI

Bridget Beauchamp, PA-C

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1396581807
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10472 Issued in AZ
Practice address
2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone
(480) 256-6444
NPI assigned
Jul 3, 2024
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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 10472 AZ Primary

Addresses

Primary practice location

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165

Mailing address

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240918002920 AZ Practitioner - Physician Assistant 8628519584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone (480) 543-2000

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10472AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Cancer Center Specialists LLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

10424 W Santa Fe Dr
Sun City, AZ 85351
Phone (623) 832-3400

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1396581807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342165",
            "telephone_number": "480-256-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "BRIDGET",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.