Individual provider Active NPI

Leon Beaulieu, AA

  • Anesthesiologist Assistant
  • Sunrise, FL
National Provider Identifier
1881947190
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA149 Issued in FL
Practice address
1613 N. Harrison Parkway
Suite 200
Sunrise, FL 33323-2853
Phone
(954) 514-4793
Fax
(954) 851-1746
NPI assigned
Oct 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA149 FL Primary

Addresses

Primary practice location

1613 N. Harrison Parkway
Suite 200
Sunrise, FL 33323-2853

Mailing address

1613 North Harrison Parkway
Suite 200
Sunrise, FL 33323-2853
Phone (954) 514-4793

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121115000283 FL Practitioner - Anesthesiology Assistant 1456502681 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

1309 N Flagler Dr
West Palm BCH, FL 33401-3406
Phone (561) 650-6271

401 NW 42ND Ave
Plantation, FL 33317-2835
Phone (954) 587-5010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of South Florida, LLC CurrentSince Jul 1, 2022 Accepting new patients
Sheridan Healthcorp, Inc CurrentSince Oct 22, 2012 Accepting new patients
Sheridan Healthcorp Inc Current Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Current Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1881947190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 NORTH HARRISON PARKWAY",
            "address_2": "SUITE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232853",
            "telephone_number": "954-514-4793",
            "fax_number": "954-851-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 N. HARRISON PARKWAY",
            "address_2": "SUITE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232853",
            "telephone_number": "954-514-4793",
            "fax_number": "954-851-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "LEON",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.