BEACHSIDE MEDICAL GROUP LLC
NPI 1144022146
Pediatrics - Neonatal-Perinatal Medicine in Pensacola, FL

Q: What is Beachside Medical Group LLC's NPI number?

The NPI number for Beachside Medical Group LLC is 1144022146. It was assigned to this organization in the NPPES registry on March 27, 2025.

Q: What is Beachside Medical Group LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Active since March 27, 2025

123 BAPTIST WAY, PENSACOLA, FL 32503(850) 473-0100(850) 473-0500 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 15, 2025, Apr 4, 2025, Mar 27, 2025 (3 updates tracked since 2025).

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About Beachside Medical Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACHSIDE MEDICAL GROUP LLC (NPI 1144022146) is a healthcare organization registered as a neonatal-perinatal medicine in Pensacola, Florida and active in the NPI registry since March 2025. The organization maintains 2 additional practice locations and lists Jaclyn H. Havinga, President, as its authorized official.

NPPES Registry Identity

NPI1144022146

Entity TypeOrganization

Primary Taxonomy2080N0001X

Legal Business NameBEACHSIDE MEDICAL GROUP LLC

Location Address123 BAPTIST WAYPensacola, FL 32503-2254

Mailing Address4951 Grande DrPensacola, FL 32504-8965 · (850) 473-0100 · Fax (850) 473-0500

Phone(850) 473-0100

Fax(850) 473-0500

Organization SubpartNo

Authorized OfficialJaclyn H. HavingaPresident · (850) 473-0100

Enumeration DateMarch 27, 2025

Last NPPES UpdateAugust 15, 20253 updates tracked since enumeration

NPPES CertifiedAugust 15, 2025

✔ NPI 1144022146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

123 BAPTIST WAY, Pensacola, FL 32503

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Secondary Practice Locations 2

Location 18383 N Davis HwyPensacola, FL 32514-6039 · Phone (850) 473-0100 · Fax (850) 473-0500

Location 25151 N 9th AvePensacola, FL 32504-8721 · Phone (850) 473-0100 · Fax (850) 473-0500

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Beachside Medical Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Beachside Medical Group LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Ramak Amjad, MD

Pediatric Medicine

NPI 1184604357

4951 GRANDE DR
Pensacola, FL 32504

(573) 268-0529

✔ PECOS8.3 mi

Jaclyn Havinga, MD

Pediatric Medicine

NPI 1730568379

5151 N 9TH AVE
Pensacola, FL 32504

(248) 410-2360

✔ PECOS8.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beachside Medical Group LLC's NPI number?

The NPI number for Beachside Medical Group LLC is 1144022146. It was assigned to this organization in the NPPES registry on March 27, 2025.

Where is Beachside Medical Group LLC located?

Beachside Medical Group LLC is located at 123 Baptist Way, Pensacola, FL 32503. The listed phone number is (850) 473-0100.

What is Beachside Medical Group LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Beachside Medical Group LLC enrolled in Medicare?

Yes. Beachside Medical Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Beachside Medical Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Pediatric Medicine, reassign their Medicare billing to Beachside Medical Group LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Beachside Medical Group LLC was last updated on August 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.