Individual provider Active NPI

Olivia Kimberly Beale, MD

  • Pediatrics Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1790426930
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME172006 Issued in FL
Practice address
4510 Pga Blvd Ste 101
Palm Beach Gardens, FL 33418-3968
Phone
(561) 627-7930
Fax
(561) 627-9574
NPI assigned
Apr 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME172006 FL Primary

Addresses

Primary practice location

4510 Pga Blvd Ste 101
Palm Beach Gardens, FL 33418-3968

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (561) 627-7930

Other practice location 1

49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049
Phone (404) 778-1440

Other identifiers 1

IdentifierTypeStateIssuer
127057700MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231121002008 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4486002045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME172006FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics PastSince Jun 29, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1648944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1790426930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "561-627-7930",
            "fax_number": "561-627-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 PGA BLVD STE 101",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183968",
            "telephone_number": "561-627-7930",
            "fax_number": "561-627-9574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033049",
            "country_code": "US",
            "telephone_number": "404-778-1440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEALE",
        "first_name": "OLIVIA",
        "middle_name": "KIMBERLY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-03",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME172006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127057700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.