Nicholas Jean Beaulieu, M.D.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

42176 Issued in GA

Practice address

920 Ponce de Leon Ave NE
920 Ponce de Leon Ave
Atlanta, GA 30306-4212

Phone

(404) 815-1957

Fax

(404) 815-1954

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Nicholas Jean Beaulieu Other name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Family Practice

Education

Morehouse School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12848/brand/1/csg/1/fhir/r4
• Direct secure messaging: nicholas.beaulieu.1@12848.direct.athenahealth.com

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.

• Highland Urgent Care and Family Medicine

  • Preferred Provider Organization
  • Atlanta, GA
  • NPI 1033238175
  NPD (past) Authorized official

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

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Piedmont Hospital, Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1679680557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 PONCE DE LEON AVE NE",
            "address_2": "920 PONCE DE LEON AVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064212",
            "telephone_number": "404-815-1957",
            "fax_number": "404-815-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 PONCE DE LEON AVE NE",
            "address_2": "920 PONCE DE LEON AVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064212",
            "telephone_number": "404-815-1957",
            "fax_number": "404-815-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "NICHOLAS",
        "middle_name": "JEAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "42176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00717076E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLAS",
            "last_name": "BEAULIEU",
            "middle_name": "JEAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chelsey Blair Beauchamp, LPC
• Laina Beaudreau, APC
• Dominic Beaufeaux, M.ED., APC
• Sherley Leon Beaufils, NP-C
• Talishe Beauford, M.S. CCC-SLP
• Georgia Beauregard, BCBA
• Frances Beausejour-Myers, LPC
• Neena Konadu Beausoleil, MSW
• Robin Beautelus
• Beautiful Mindz ABA Center LLC

• Preferred Provider Organization in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Preferred Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.

Verify at the official NPI Registry.