Individual provider Active NPI

Jeffrey C Beasom, PT

  • Orthopedic Physical Therapist
  • Ocoee, FL
National Provider Identifier
1598905481
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT5738 Issued in FL
Practice address
2706 Rew Cir
Ocoee, FL 34761-4215
Phone
(407) 614-8337
Fax
(407) 614-8341
NPI assigned
Mar 4, 2009
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5738 FL
Orthopedic Physical Therapist 2251X0800X PT5738 FL Primary

Addresses

Primary practice location

2706 Rew Cir
Ocoee, FL 34761-4215

Mailing address

2706 Rew Cir
Ocoee, FL 34761-4215
Phone (407) 614-8337

Other practice location 1

1301 Sligh Blvd
Orlando, FL 32806-3901
Phone (407) 649-6888

Other identifiers 1

IdentifierTypeStateIssuer
000698700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231005002684 FL Practitioner - Physical Therapist in Private Practice 2961857255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

2706 Rew Cir
Ocoee, FL 34761-4215
Phone (321) 842-4800

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5738FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

2706 Rew Cir
Ocoee, FL 34761
Phone (321) 842-4800

1301 Sligh Blvd
Orlando, FL 32806
Phone (407) 649-6888

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1598905481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 REW CIR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614215",
            "telephone_number": "407-614-8337",
            "fax_number": "407-614-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 REW CIR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614215",
            "telephone_number": "407-614-8337",
            "fax_number": "407-614-8341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Sligh Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328063901",
            "country_code": "US",
            "telephone_number": "407-649-6888",
            "fax_number": "407-246-0135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEASOM",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-04",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT5738",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT5738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000698700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.