Active NPI
Haley Lane Beuttell
- Physician Assistant
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9118024
- Practice address
- 10475 Centurion Pkwy N Ste 303
Jacksonville, FL 32256-5004 - Phone
- (904) 399-0350
- NPI assigned
- Oct 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 9118024 | FL | |
| Physician Assistant | 363A00000X | 9118024 | FL | Primary |
Addresses
Primary practice location
10475 Centurion Pkwy N Ste 303
Jacksonville, FL 32256-5004
Mailing address
10475 Centurion Pkwy N Ste 303
Jacksonville, FL 32256-5004
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10475 Centurion Pkwy N
Suite 303
Jacksonville, FL 32256-5004
Phone (904) 399-0350
Hospital & facility affiliations
- Baptist Health Medical Center - Jacksonville
- Baptist Medical Center Beaches
- Southeast Georgia Health System -- Camden Campus
- Baptist Medical Center - Nassau
- Brooks Rehabilitation Hospital University Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.79 of 100
- Quality
- 64.42
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.88
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9118024 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Florida Surgeons, PA | Current | Accepting new patients | |
| North Florida Surgeons, PA | Current | Accepting new patients |
Locations
11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223
10475 Centurion Pkwy N
Ste 303
Jacksonville, FL 32256
Phone (904) 399-0350
11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937
Interoperability endpoints
- haley.beuttell.1@9109.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Surgery Physician
- Jacksonville, FL
- NPI 1912953290
-
- Orthopaedic Surgery Physician
- Gulf Breeze, FL
- NPI 1871442053
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fernandina Beach, FL
- NPI 1518024462
-
- General Acute Care Hospital
- Jacksonville Beach, FL
- NPI 1821155912
-
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1376114413
Inpatient rehabilitation facility
-
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1912947748
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
-
- General Acute Care Hospital
- Saint Marys, GA
- NPI 1194744326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1508647330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10475 CENTURION PKWY N STE 303",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322565004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10475 CENTURION PKWY N STE 303",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322565004",
"telephone_number": "904-399-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEUTTELL",
"first_name": "HALEY",
"middle_name": "LANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-09",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "9118024",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9118024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.