Jacqueline Beauregard (NPI# 1962069997, PAC ID# 6507199858) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1962069997 |
| PAC ID by PECOS | 6507199858 |
| Professional Enrollment ID | I20190531001777 |
| Full Name | Jacqueline Beauregard |
| Organization Legal Name | CARDIOLOGY ASSOC OF PORT HURON |
| Address |
1222 10th Ave Port Huron MI 48060-3406 |
| Phone Number | 8109859681 |
| Gender | F |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2019 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1658348776 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230216 | MCLAREN PORT HURON |
| 230031 | LAKE HURON MEDICAL CENTER |
| 231314 | MCKENZIE HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 1222 10th Ave, Port Huron, MI 48060-3406 | 8109859681 | CARDIOLOGY ASSOC OF PORT HURON |
| Organization Legal Name | CARDIOLOGY ASSOC OF PORT HURON |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elias Skaf | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Crystal Kay Pennell | Nurse Practitioner | Cardiology Assoc of Port Huron | 4190 24th Ave, Suite 203, Fort Gratiot, MI 48059-3884 |
| Caitlin Smith | Nurse Practitioner | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Ajay C Krishen | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Bashar Samman | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Suresh R Tumma | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Tamara Dawn Yoas | Nurse Practitioner | Cardiology Assoc of Port Huron | 4190 24th Ave, Suite 203, Fort Gratiot, MI 48059-3884 |
| Sivaji Gundlapalli | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Beeravolu R Reddy | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Vrajmohan C Parikh | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Street Address |
1222 10TH AVE |
| City | PORT HURON |
| State | MI |
| Zip | 48060-3406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elias Skaf | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Caitlin Smith | Nurse Practitioner | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Ajay C Krishen | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Bashar Samman | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Suresh R Tumma | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Sivaji Gundlapalli | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Beeravolu R Reddy | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Vrajmohan C Parikh | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Madhusudhan C Reddy | Cardiovascular Disease (cardiology) | Cardiology Assoc of Port Huron | 1222 10th Ave, Port Huron, MI 48060-3406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Annette M Mercatante | Family Medicine | 2215 Court, Port Huron, MI 48060 | |
| Fahim Kamal Ibrahim | Ophthalmology | 2025 Holland Ave, Port Huron, MI 48060-1519 | |
| George J Carley Jr. | Family Medicine | George J Carley Do PC | 1943 Holland Ave, Port Huron, MI 48060-1519 |
| Reid S Stromberg | Family Medicine | George J Carley Do PC | 1943 Holland Ave, Port Huron, MI 48060-1519 |
| Kamal Fahim | Ophthalmology | 2025 Holland Ave, Port Huron, MI 48060-1519 | |
| Mark G Kanitz | Emergency Medicine | Medexpress Urgent Care PC - Michigan | 3550 Pine Grove Ave, Port Huron, MI 48060-1944 |
| Dana L Wolfe | Nurse Practitioner | Medexpress Urgent Care PC - Michigan | 3550 Pine Grove Ave, Port Huron, MI 48060-1944 |
| Jay S Guikema | Nurse Practitioner | Medexpress Urgent Care PC - Michigan | 3550 Pine Grove Ave, Port Huron, MI 48060-1944 |
| Dena R Nader | Family Medicine | Medexpress Urgent Care PC - Michigan | 3550 Pine Grove Ave, Port Huron, MI 48060-1944 |
| Shanae D Bartlett | Nurse Practitioner | Medexpress Urgent Care PC - Michigan | 3550 Pine Grove Ave, Port Huron, MI 48060-1944 |
| Find all physicians in zip 48060 | |||
| City | PORT HURON |
| Zip Code | 48060 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PORT HURON + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jacqueline Beauregard.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.