Individual provider Active NPI

Michael James Beck, MD

  • Emergency Medicine Physician
  • Orange Park, FL
National Provider Identifier
1417105404
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
252869 Issued in NY
Practice address
2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone
(904) 639-8500
NPI assigned
Sep 3, 2008
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 156694 FL
Emergency Medicine Physician 207P00000X 252869 NY Primary

Addresses

Primary practice location

2001 Kingsley Ave
Orange Park, FL 32073-5148

Mailing address

262 Woodland Greens Dr
Ponte Vedra, FL 32081-8428
Phone (631) 682-7767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221201003163 FL Practitioner - Emergency Medicine 3274683305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156694FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Samaritan Emergency Medical Services, PC Emergency Medicine Past Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

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.

Hospital & facility affiliations 1

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1417105404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 WOODLAND GREENS DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320818428",
            "telephone_number": "631-682-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735148",
            "telephone_number": "904-639-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "156694",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "252869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.