NPI 1063100873

Jacob Martin Beane, PAC

Practitioner Physician Assistant Cranston, RI

Practice location

Address: 712 Oaklawn Ave, Cranston, RI 02920-2858
Phone: (401) 944-0044
Mailing address: 455 Toll Gate Road Prc and Credentialing, Warwick, RI 02886-2759

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA01574 (RI)

Other Physician Assistant providers in Rhode Island →

Registry record

NPI: 1063100873
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Apr 2023
Record last updated: 20 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.