Individual provider Active NPI

Beena Wycliffe, M.D.

  • Emergency Medicine Physician
  • Homestead, FL
National Provider Identifier
1770538662
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME168525 Issued in FL
Practice address
975 Baptist Way
Homestead, FL 33033-7600
Phone
(786) 243-8000
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A82400 CA
Emergency Medicine Physician 207P00000X ME168525 FL Primary

Addresses

Primary practice location

975 Baptist Way
Homestead, FL 33033-7600

Mailing address

975 Baptist Way
Homestead, FL 33033-7600
Phone (786) 243-8510

Other identifiers 2

IdentifierTypeStateIssuer
ME168525MedicaidFL
00A824000MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040419000122 CA Practitioner - Emergency Medicine 8022003128 Reassigns benefits to 1 organization
I20241021002442 FL Practitioner - Emergency Medicine 8022003128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians

Practice addresses (Care Compare)

975 Baptist Way
Homestead Hospital
Homestead, FL 33033-7600
Phone (786) 243-8000

Hospital & facility affiliations

  • Homestead Hospital Hospital, Homestead, FL, CCN 100125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A82400CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Aug 19, 2016 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

651 E 25th St
Hialeah, FL 33013
Phone (305) 835-4370

975 Baptist Way
Homestead, FL 33033
Phone (786) 243-8000

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1770538662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 BAPTIST WAY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337600",
            "telephone_number": "786-243-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 BAPTIST WAY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337600",
            "telephone_number": "786-243-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCLIFFE",
        "first_name": "BEENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A82400",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME168525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ME168525",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A824000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.