Individual provider Active NPI

Jennifer Lynn Beal, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Ann Arbor, MI
National Provider Identifier
1790918290
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
5101018336 Issued in MI
Practice address
1500 E Medical Center Drive
Ann Arbor, MI 48109-5364
Phone
(734) 936-4000
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101018336 MI
Internal Medicine Physician 207R00000X L1588240 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 5101018336 MI Primary

Addresses

Primary practice location

1500 E Medical Center Drive
Ann Arbor, MI 48109-5364

Mailing address

3621 State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140307000823 MI Practitioner - Geriatric MedicinePractitioner - Internal Medicine 4587894712 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1588240MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Internal Medicine CurrentSince Jun 27, 2017 Accepting new patients
Regents of the University of Michigan CurrentSince Jun 27, 2017 Accepting new patients
Regents of the University of Michigan Internal Medicine Current Accepting new patients
Riverview Acquisition Company, LLC Past Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Evangelical Homes of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

4701 E Huron River Dr
Ann Arbor, MI 48105
Phone (734) 975-2600

380 Parkland Plz
Ste 110
Ann Arbor, MI 48103
Phone (345) 395-0807

355 Huronview Blvd
Ann Arbor, MI 48103
Phone (734) 761-3800

4260 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-5715

440 W Russell St
Saline, MI 48176
Phone (734) 429-9401

Interoperability endpoints

  • Direct secure messaging: jbeal94505@direct.med.umich.edu

Organizations & group practices 6

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": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790918290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095364",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAL",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101018336",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "L1588240",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "5101018336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.