Individual provider Active NPI

Lori E Beauchamp, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1922433465
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4756 Issued in MA
Practice address
450 Brookline Ave
Boston, MA 02215
Phone
(508) 488-3700
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA4756 MA Primary

Addresses

Primary practice location

450 Brookline Ave
Boston, MA 02215

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131209000731 MA Practitioner - Physician Assistant 0840427381 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA4756MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Physician Assistant CurrentSince Oct 7, 2013 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 7, 2013 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jun 15, 2015 Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: beauchamp.lori.dfci@direct.partners.masshiway.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1922433465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "508-488-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "LORI",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.