MS. JACQUELYN RAY BEEMER (PA-C) – Physician Assistant, NPI 1396248415

MS. JACQUELYN RAY BEEMER (PA-C) is a healthcare provider. based in Fort wayne, Indiana. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 10002412A (IN). The NPI Number for MS. JACQUELYN RAY BEEMER (PA-C) is 1396248415

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MS. JACQUELYN RAY BEEMER (PA-C)
NPI
1396248415
Phone
(260) 436-9696
Address
5650 COVENTRY LN
Enumeration Date
15 March 2018
Last Update Date
15 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2604369696
Graduation Year
2017 (9 years ago)
PAC ID
8022371418
Group Practice PAC ID
3375685092
Professional Enrollment ID
I20180417002890
Address ID
IN468047140FO5650XLNXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,499 PHYSICIAN ASSISTANT in IN

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Provider Addresses for MS. JACQUELYN RAY BEEMER (PA-C)

  • 5650, Coventry Lane, Liberty Hills, Fort Wayne, Allen County, Indiana, 46804, United States

    FORT WAYNE, IN 468047140

    Phone: (260) 436-9696

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 423 Open Payments records for all available years, with a total value of $8,755.

Total Amount is formed as General ($8,755) + Research ($0) + Ownership ($0) = $8,755.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($1,576).

Total Amount

$8,755

General + Research + Ownership

Payments

423

Total payment records

General Amount

$8,755

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-04-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180417002890IPhysician AssistantINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths515120$0
99213Established patient office or other outpatient visit, 20-29 minutes370327$0
17000Destruction of precancer skin growth, 1 growth184169$0
11102Biopsy of related skin growth, first growth139128$0
99214Established patient office or other outpatient visit, 30-39 minutes134124$0
View full utilization report →

Insurance plans in this area (ZIP 46804)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375685092View full group profile
NameSpecialtyState
Physician AssistantIN
D E R M A T O L O G YIN
Physician AssistantIN

Reviews

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Frequently asked questions

Can I verify MS. JACQUELYN RAY BEEMER (PA-C) with an NPI only?
You can start verification with NPI 1396248415 for MS. JACQUELYN RAY BEEMER (PA-C), then check state licensing separately.
Does the file indicate MS. JACQUELYN RAY BEEMER (PA-C) is practicing under active NPI?
Directory data currently reports MS. JACQUELYN RAY BEEMER (PA-C) as active.
What is MS. JACQUELYN RAY BEEMER (PA-C)'s specialty?
The listing groups MS. JACQUELYN RAY BEEMER (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is MS. JACQUELYN RAY BEEMER (PA-C) based?
MS. JACQUELYN RAY BEEMER (PA-C) is tied to Fort Wayne, Indiana in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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