Janmary Beauchamp, PA
Individual provider Active NPI Physician Assistant · Debary, FL
NPI 1972871044 · NPPES record last updated Dec 5, 2011
Key facts
- NPI
- 1972871044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9105755 (FL)
- Practice address
- 2893 Enterprise Rd
Suite 100
Debary, FL 32713-2784 - Phone
- (386) 789-8600
- Fax
- (386) 789-0219
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Leavitt Medical Associates of Florida Inc
Practice addresses (Care Compare)
1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100
1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812
2893 Enterprise Rd
Suite 100
Debary, FL 32713-2784
Phone (386) 789-8600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120117000332 | FL | Practitioner - Physician Assistant | 2264609221 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles (3 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leavitt Medical Associates of Florida Inc | Current |
Accepting new patients | |
| Leavitt Medical Associates of Florida Inc | Current |
Accepting new patients | |
| Leavitt Medical Associates of Florida Inc | Past | Accepting new patients |
Locations
2893 Enterprise Rd
Ste 100
Debary, FL 32713
Phone 3867898600 ext. 38678
151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293
1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100
1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9105755 | FL | Yes |
Addresses
Primary practice location
2893 Enterprise Rd
Suite 100
Debary, FL 32713-2784
Mailing address
2600 Lake Lucien Dr
Suite 180
Maitland, FL 32751-7233
Phone (407) 875-2080
Other providers in Debary, FL
- Alvan William Barber
- Marialana Barber
- Hunter Barnard
- Jaymee Barthe
- Jaclyn Batts
- Behavior Analysis Support Services, Inc
- Paula Jean Belcher
- Jacklyn Iris Belenky
- Sarah N Bennett
- Biped Medical
All providers in Debary, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.