MEDICARE: JACOB MARTIN BEANE PA-C

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	363A00000X	Physician Assistant	PA01574	RI

General Provider Information

NPI Number	:	1063100873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB MARTIN BEANE PA-C

Provider Business Mailing Address
First Line	:	455 TOLL GATE ROAD
Second Line	:	PRC AND CREDENTIALING
City	:	WARWICK
State	:	RI
Zip	:	02886-2759
Country	:	US
Telephone Number	:	401-273-0641
Fax Number	:	401-273-2919

Provider Business Practice Location Address
First Line	:	215 TOLL GATE RD STE 104
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-4463
Country	:	US
Telephone Number	:	401-921-7290
Fax Number	:	401-736-4546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2023
Last Update Date	:	02/03/2026

Similar Medicare Providers

1720502677 — MR. RAFAEL DAVID PENA PTA
Practice Location Address:

2871 POST RD , PREHAB SPORTS MEDICARE SERVICES INC.
WARWICK, RI
02886-0076

Practice Phone: 401-463-3060
Practice Fax: 401-732-1045

1629181268 — DAVID J COIA DO
Practice Location Address:

215 TOLL GATE RD STE 104
WARWICK, RI
02886-4463

Practice Phone: 401-921-7290
Practice Fax: 401-921-6194

1871588947 — PIERRE A CARON MD
Practice Location Address:

215 TOLL GATE RD STE 104
WARWICK, RI
02886-4463

Practice Phone: 401-921-7290
Practice Fax: 401-921-6194

1043419617 — KIMBERLY M SMITH LICSW
Practice Location Address:

215 TOLL GATE RD STE 104
WARWICK, RI
02886-4463

Practice Phone: 401-921-7290
Practice Fax: 401-921-6194

1598943250 — DR. MARIA A. SORIANO PISATURO M.D.
Practice Location Address:

215 TOLL GATE RD STE 104
WARWICK, RI
02886-4463

Practice Phone: 401-921-7290
Practice Fax: 401-921-6194

1043535594 — MRS. JULIA K BASS BCBA
Practice Location Address:

215 TOLL GATE RD STE 309
WARWICK, RI
02886-4463

Practice Phone: 401-305-8937
Practice Fax:

Directions to “ JACOB MARTIN BEANE PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.