Erica Renae Van Beuge, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7596 Issued in AZ

Practice address

287 E Hunt Hwy Ste 105
San Tan Valley, AZ 85143-5096

Phone

(480) 677-8282

Fax

(888) 316-1686

NPI assigned

Apr 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Erica Renae Guevara Former name

Medicare fee-for-service enrollment

Enrolled in AZ, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Okaloosa Clinic CorpGroup PAC ID 0244205565, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: erica.van.beuge.1@1523.direct.athenahealth.com
• FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

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.

• North Okaloosa Clinic Corp

  • Internal Medicine Physician
  • Crestview, FL
  • NPI 1659329852
  Medicare reassignment Care Compare group
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1144764432
  Medicare reassignment
• Good Health Medical, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023828431
  NPD
• Good Health Medical, PLLC

  • Family Medicine Physician
  • San Tan Valley, AZ
  • NPI 1063573079
  NPD
• North Okaloosa Clinic Corp

  • Durable Medical Equipment & Medical Supplies
  • Crestview, FL
  • NPI 1477738896
  NPD
• Livn, P.C.

  • Family Medicine Physician
  • Chandler, AZ
  • NPI 1245759307
  NPD (past)

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

• Crestview Hospital Company, LLC

  • General Acute Care Hospital
  • Crestview, FL
  • NPI 1104897859
  Care Compare affiliation

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1770045833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262617",
            "telephone_number": "480-677-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 E HUNT HWY STE 105",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435096",
            "telephone_number": "480-677-8282",
            "fax_number": "888-316-1686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1599 J St",
            "address_purpose": "LOCATION",
            "city": "Grand Forks AFB",
            "state": "ND",
            "postal_code": "582056306",
            "country_code": "US",
            "telephone_number": "701-747-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN BEUGE",
        "first_name": "ERICA",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61526401",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008420",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA100449",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12310",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14186",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144809",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "GUEVARA",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.