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BEACH MEDICAL SPECIALIST PA
NPI 1720125479
Internal Medicine in Jacksonville, FL

Active since January 31, 2007CLIA 10D1043673 · Waiver
9860 BEACH BLVD, JACKSONVILLE, FL 32246(904) 200-2978(904) 807-9114 Get Directions Write a Review

NPPES record last updated: March 6, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Beach Medical Specialist Pa NPPES

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

BEACH MEDICAL SPECIALIST PA (NPI 1720125479) is a healthcare organization registered as an internal medicine in Jacksonville, Florida and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through July 31, 2027 and lists Alejandro Cabigting Dizon, President, as its authorized official.

NPPES Registry Identity

NPI1720125479
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameBEACH MEDICAL SPECIALIST PA
Location Address9860 BEACH BLVDJacksonville, FL 32246-4704
Mailing Address9860 Beach BlvdJacksonville, FL 32246-4704 · (904) 200-2978 · Fax (904) 807-9114
Phone(904) 200-2978
Fax(904) 807-9114
Organization SubpartNo
Authorized OfficialAlejandro Cabigting DizonPresident · (904) 200-2978
Enumeration DateJanuary 31, 2007
Last NPPES UpdateMarch 6, 2024
NPPES CertifiedMarch 6, 2024
✔ NPI 1720125479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME88405
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
9860 BEACH BLVD, Jacksonville, FL 32246
Open in Google Maps ↗

Other Identifiers 1

Medicaid272420100FL

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Beach Medical Specialist Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Beach Medical Specialist PA, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Alejandro Dizon, MD
Internal Medicine
NPI 1225057193
9860 BEACH BLVD
Jacksonville, FL 32246
(904) 807-9112
✔ PECOS✔ Accepts MedicareSame address
Jean Serna, APRN
Nurse Practitioner
NPI 1831876697
9860 BEACH BLVD
Jacksonville, FL 32246
(904) 807-9112
✔ PECOSSame address
Arianne Vitug, APRN
Nurse Practitioner
NPI 1447021878
9860 BEACH BLVD
Jacksonville, FL 32246
(904) 807-9112
✔ PECOSSame address
Tatiana Barsukova, M.D.
Addiction Medicine
NPI 1093974057
3625 UNIVERSITY BLVD S
Jacksonville, FL 32216
(904) 391-1330
✔ PECOS2.8 mi
Jeffrey Vongjesda, M.S., APRN, FNP-C
Nurse Practitioner
NPI 1003286824
3728 PHILIPS HWY STE 34
Jacksonville, FL 32207
(904) 399-2766
✔ PECOS4.7 mi
Analyn Tesoro-Ofiara, APRN
Nurse Practitioner
NPI 1225529761
1029 ATLANTIC BLVD
Atlantic Beach, FL 32233
(904) 246-7520
✔ PECOS✔ Accepts Medicare9.0 mi
Antonette Arevalo, APRN
Nurse Practitioner
NPI 1285242743
900 BEACH BLVD
Jacksonville Beach, FL 32250
(904) 249-0335
✔ PECOS✔ Accepts Medicare9.4 mi
Chinenye Ezedike, MD
Family Practice
NPI 1437319159
600 GRESHAM DR FL 5
Norfolk, VA 23507
(757) 388-3198
✔ PECOS✔ Accepts Medicare545 mi
Naji Nouneh, M.D.
Internal Medicine
NPI 1699708222
13742 AMAR RD
La Puente, CA 91746
(626) 919-0400
✔ PECOS2,139 mi

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 10D1043673

Beach Medical Specialist PA · Jacksonville, FL
Active · expires Jul 31, 2027
CLIA Number10D1043673
Laboratory TypePhysician Office
Certificate Effective DateAugust 1, 2025
Certificate Expiration DateJuly 31, 2027
Laboratory DirectorAlejandro C. Dizon
Laboratory Phone(904) 807-9112
Laboratory LocationBeach Medical Specialist PA9860 Beach Blvd, Jacksonville, FL 32246
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Beach Medical Specialist PA's NPI number?

The NPI number for Beach Medical Specialist PA is 1720125479. It was assigned to this organization in the NPPES registry on January 31, 2007.

Where is Beach Medical Specialist PA located?

Beach Medical Specialist PA is located at 9860 Beach Blvd, Jacksonville, FL 32246. The listed phone number is (904) 200-2978.

What is Beach Medical Specialist PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Beach Medical Specialist PA enrolled in Medicare?

Yes. Beach Medical Specialist PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Beach Medical Specialist PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 4 Medicare specialties reassign their Medicare billing to Beach Medical Specialist 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. The largest specialties are Nurse Practitioner (5), Internal Medicine (2) and Addiction Medicine (1). Of these, 3 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Beach Medical Specialist PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1043673) is associated with this NPI, valid through July 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beach Medical Specialist PA accept?

Health plans from AvMed list Beach Medical Specialist 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 Beach Medical Specialist PA was last updated on March 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.