NPIMap

Individual provider Active NPI

Jonathan D Beck, M.D.

  • Family Medicine Physician
  • New Milford, CT
National Provider Identifier
1578631982
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042308 Issued in CT
Practice address
11 Old Park Lane Rd
New Milford, CT 06776-2507
Phone
(860) 355-1149
NPI assigned
Dec 1, 2006
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042308 CT Primary

Addresses

Primary practice location

11 Old Park Lane Rd
New Milford, CT 06776-2507

Mailing address

11 Old Park Lane Rd
New Milford, CT 06776-2507
Phone (806) 355-1149

Other identifiers 2

IdentifierTypeStateIssuer
008003881MedicaidCT
830401703OtherCTTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000342 CT Practitioner - Family Practice 0042270514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Milford Medical Group, LLCGroup PAC ID 3678469384, 10 clinicians

Practice addresses (Care Compare)

11 Old Park Lane
New Milford, CT 06776-2507

11 Old Park Lane Rd
New Milford, CT 06776-2507
Phone (860) 355-1149

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042308CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Milford Medical Group, LLC CurrentSince Jul 1, 2011 Accepting new patients
Nuvance Health Medical Practice CT, Inc. Family Medicine PastSince Apr 27, 2015 Accepting new patients
Family Medicine on the Green Family Medicine PastSince Jan 1, 1990 Accepting new patients

Locations

11 Old Park Lane Rd
New Milford, CT 06776
Phone (860) 355-1149

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jonathan.beck.p1@direct.nmmg.nextgenshare.com

Organizations & group practices 3

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 10

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1578631982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 OLD PARK LANE RD",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762507",
            "telephone_number": "806-355-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 OLD PARK LANE RD",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762507",
            "telephone_number": "860-355-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "042308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003881",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "830401703",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

Verify at the official NPI Registry.