Individual provider Active NPI

Beth M Amundsen, M.D.

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1962669861
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME177064 Issued in FL
Practice address
55 Fruit St
Suite
Boston, MA 02114-2621
Phone
(617) 643-4533
NPI assigned
May 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X ME177064 FL
Surgery Physician 208600000X ME177064 FL Primary

Addresses

Primary practice location

55 Fruit St
Suite
Boston, MA 02114-2621

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (904) 953-2000

Other practice location 1

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bamundsen2597546@ehrdirect.mayoclinicmsg.org

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
I20251111002579 FL Practitioner - General Surgery 4183851553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

PO Box
Minneapolis, MN 55486

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME177064FLMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Nov 3, 2025 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Nov 3, 2025 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

Interoperability endpoints

  • Direct secure messaging: bamundsen2597546@ehrdirect.mayoclinicmsg.org

Organizations & group practices 2

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1962669861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "SUITE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-643-4533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 San Pablo Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322241865",
            "country_code": "US",
            "telephone_number": "904-953-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMUNDSEN",
        "first_name": "BETH",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "FL",
            "license": "ME177064",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME177064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bamundsen2597546@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.