Individual provider Active NPI

Mark L Beauchamp, MD

  • Internal Medicine Physician
  • Maitland, FL
National Provider Identifier
1811911373
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME126056 Issued in FL
Practice address
1184 Charming St
Maitland, FL 32751-4263
Phone
(505) 269-8313
Fax
(407) 264-6188
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME126056 FL Primary

Addresses

Primary practice location

1184 Charming St
Maitland, FL 32751-4263

Mailing address

1184 Charming St
Maitland, FL 32751-4263
Phone (505) 269-8313

Other identifiers 1

IdentifierTypeStateIssuer
5951MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170123000151 FL Practitioner - Internal Medicine 9234147489 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6116NMMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Inpatient Medicine LLC Internal Medicine CurrentSince Nov 14, 2016 Accepting new patients

Locations

917 Rinehart Rd
Ste 1051
Lake Mary, FL 32746
Phone (407) 562-9170

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1811911373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1184 CHARMING ST",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514263",
            "telephone_number": "505-269-8313",
            "fax_number": "407-264-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 CHARMING ST",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514263",
            "telephone_number": "505-269-8313",
            "fax_number": "407-264-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME126056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5951",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.