BEACHES FAMILY MEDICINE PA
NPI 1407986920
Family Medicine in Jacksonville Beach, FL
About Beaches Family Medicine Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEACHES FAMILY MEDICINE PA (NPI 1407986920) is a healthcare organization registered as a family medicine in Jacksonville Beach, Florida and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through November 29, 2026 and lists Vaughn E Dobalian, Physician And Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Beaches Family Medicine Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Beaches Family Medicine PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D2016952
Beaches Family Medicine · Jacksonville Beach, FLFrequently 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 Beaches Family Medicine PA's NPI number?
The NPI number for Beaches Family Medicine PA is 1407986920. It was assigned to this organization in the NPPES registry on March 6, 2007.
Where is Beaches Family Medicine PA located?
Beaches Family Medicine PA is located at 228 6th Ave S, Jacksonville Beach, FL 32250. The listed phone number is (904) 247-1911.
What is Beaches Family Medicine PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Beaches Family Medicine PA enrolled in Medicare?
Yes. Beaches Family Medicine PA is registered in the Medicare PECOS enrollment system.
When is Beaches Family Medicine PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Beaches Family Medicine PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Beaches Family Medicine PA. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Beaches Family Medicine PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2016952) is associated with this NPI, valid through November 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Beaches Family Medicine PA accept?
Health plans from Ambetter Health, Ambetter of Alabama and Molina Healthcare list Beaches Family Medicine PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Beaches Family Medicine PA was last updated on August 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Beaches Family Medicine Pa · NPI 1407986920
Family Medicine organization in Jacksonville Beach, Florida. Organization record, active in the CMS NPPES registry since March 6, 2007.
## Identity
- **NPI:** 1407986920 (Entity type: Organization)
- **Enumerated:** March 6, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Vaughn Dobalian, PHYSICIAN AND OWNER
## Practice location
- **Address:** 228 6TH AVE S, Jacksonville Beach, FL 32250-6634
- **Phone:** (904) 247-1911 · **Fax:** (904) 247-9736
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 24, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1407986920) · Data from the CMS NPPES public registry.