Individual provider Active NPI

Hailey Adison Beach, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1710767272
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2411 W Belvedere Ave Ste 102
Baltimore, MD 21215-5217
Phone
(386) 341-9246
NPI assigned
Oct 3, 2023
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2411 W Belvedere Ave Ste 102
Baltimore, MD 21215-5217

Mailing address

3340 Antica St
Fort Myers, FL 33905-1500
Phone (386) 341-9246

Other practice location 1

3340 Antica St
Fort Myers, FL 33905-1500
Phone (386) 341-9246

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231205000408 MD Practitioner - Physician Assistant 3971951724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216

2411 W Belvedere Ave
Baltimore, MD 21215-5217

2411 W Belvedere Ave 5TH Floor
Sinai Ophthalmology Associates
Baltimore, MD 21215-5217
Phone (410) 601-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Nov 27, 2023 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Nov 27, 2023 Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2411 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-8314

2411 W Belvedere Ave
Ste 102
Baltimore, MD 21215
Phone (386) 341-9246

Organizations & group practices 4

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 2

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": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1710767272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 ANTICA ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339051500",
            "telephone_number": "386-341-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 W BELVEDERE AVE STE 102",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155217",
            "telephone_number": "386-341-9246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3340 Antica St",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339051500",
            "country_code": "US",
            "telephone_number": "386-341-9246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEACH",
        "first_name": "HAILEY",
        "middle_name": "ADISON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.