Individual provider Active NPI

Lynda M Beaupin, MD

  • Pediatric Hematology & Oncology Physician
  • St Petersburg, FL
National Provider Identifier
1790960904
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
ME135758 Issued in FL
Practice address
601 5TH St S Ste 302
St Petersburg, FL 33701
Phone
(727) 767-4176
Fax
(727) 767-4379
NPI assigned
Jan 7, 2008
Last updated
May 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X ME135758 FL Primary

Addresses

Primary practice location

601 5TH St S Ste 302
St Petersburg, FL 33701

Mailing address

601 5TH St S Ste 302
St Petersburg, FL 33701-4804
Phone (727) 767-4176

Other identifiers 1

IdentifierTypeStateIssuer
024445300MedicaidFL

Other names 1

  • Lynda Kwon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. Pediatric Hematology-Oncology CurrentSince Jun 19, 2018 Accepting new patients

Locations

601 5th St S
Ste 302
St Petersburg, FL 33701
Phone (727) 767-4176

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

Interoperability endpoints

  • Direct secure messaging: lbeaupin741823@direct.hopkinsmedicine.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1790960904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 5TH ST S STE 302",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-4176",
            "fax_number": "727-767-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S STE 302",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33701",
            "telephone_number": "727-767-4176",
            "fax_number": "727-767-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUPIN",
        "first_name": "LYNDA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "FL",
            "license": "ME135758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024445300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDA",
            "last_name": "KWON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.