MEDICARE: BJA INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	HCC4910	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	V2200	OTHER	FL	BLUE CROSS & BLUE SHIELD
2	3237168001	OTHER	FL	CIGNA
3	7441067	OTHER	FL	AETNA PPO AND POS
4	198180	OTHER	FL	STAYWELL HMO
5	198180	OTHER	FL	WELLCARE HMO
6	2239829	OTHER	FL	AETNA HMO

General Provider Information

NPI Number	:	1831196823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BJA INCORPORATED

Provider Business Mailing Address
First Line	:	99 ROSEWOOD DR STE 245
Second Line	:
City	:	DANVERS
State	:	MA
Zip	:	01923-4537
Country	:	US
Telephone Number	:	978-536-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	598 NORTHLAKE BLVD STE 1040
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701
Country	:	US
Telephone Number	:	407-834-1023
Fax Number	:	866-830-4248

Authorized Official
Title or Position	:	EVP CLINICAL OPERATIONS
Name	:	JANICE SHOCK
Credential	:
Telephone Number	:	214-532-3757

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	05/10/2022

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Directions to “BJA INCORPORATED ” Practice Location

Language	Start Address	Practice Location

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