Ijose Beverly, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95000198 Issued in CA

Practice address

3434 Midway Dr Ste 2001
San Diego, CA 92110-4924

Phone

(619) 325-1161

Fax

(619) 325-1717

NPI assigned

Jan 21, 2014

Last updated

Jul 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Algos Inc a Medical CorporationGroup PAC ID 8123917713, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Pasadena, CA
  • NPI 1497747356
  Medicare reassignment Care Compare group NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Visalia, CA
  • NPI 1245832419
  NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Oceanside, CA
  • NPI 1265810576
  NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Simi Valley, CA
  • NPI 1063890275
  NPD (past)

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1689097065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 MIDWAY DR STE 2001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104924",
            "telephone_number": "619-325-1161",
            "fax_number": "619-325-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 MIDWAY DR STE 2001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104924",
            "telephone_number": "619-325-1161",
            "fax_number": "619-325-1717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Fourth Ave Ste 19",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919103898",
            "country_code": "US",
            "telephone_number": "619-761-5308",
            "fax_number": "619-591-1910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEVERLY",
        "first_name": "IJOSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "806970",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95000198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beuchooseu Therapy
• Page Naomi Beukelman, AU.D.
• Kirra Beutnagel, DPT
• Elizabeth May Beutter, MD
• David Temple Beverly IV, M.D.
• Juanita Beverly
• Kristina Paige Bevill
• Rebecca Anne Beville, LMFT
• Nicholas Bevins, MD PHD
• Bewell Home Occupational Therapy PC

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.