Individual provider Active NPI

Brendon A Beatrice, D.C.

  • Chiropractor
  • Raritan, NJ
National Provider Identifier
1801800073
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00530500 Issued in NJ
Practice address
575 State Route 28 Ste 207
Raritan, NJ 08869-1354
Phone
(908) 252-9900
Fax
(908) 252-9901
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00530500 NJ Primary

Addresses

Primary practice location

575 State Route 28 Ste 207
Raritan, NJ 08869-1354

Mailing address

575 State Route 28 Ste 207
Raritan, NJ 08869-1354
Phone (908) 252-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050524000239 NJ Practitioner - Chiropractic 8325080047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1130 Rte
202 BLDG E
Raritan, NJ 08869-1490
Phone (908) 393-9909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00530500NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Somerset Spine & Wellness Group, PC PastSince Mar 31, 2005 Accepting new patients

Organizations & group practices 4

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801800073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 STATE ROUTE 28 STE 207",
            "city": "RARITAN",
            "state": "NJ",
            "postal_code": "088691354",
            "telephone_number": "908-252-9900",
            "fax_number": "908-252-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 STATE ROUTE 28 STE 207",
            "city": "RARITAN",
            "state": "NJ",
            "postal_code": "088691354",
            "telephone_number": "908-252-9900",
            "fax_number": "908-252-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATRICE",
        "first_name": "BRENDON",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00530500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raritan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.