Individual provider Active NPI

Rachel Ivy Grace Magistre-Legend, PA-C

  • Physician Assistant
  • Tamuning, GU
National Provider Identifier
1013117175
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-151 Issued in GU
Practice address
388 Ypao Rd
Tamuning, GU 96913-3701
Phone
(671) 646-8881
Fax
(671) 646-1292
NPI assigned
Jul 18, 2007
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-151 GU Primary
Social Worker 104100000X NU

Addresses

Primary practice location

388 Ypao Rd
Tamuning, GU 96913-3701

Mailing address

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

Other names 1

  • Rachel Magistre Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251103003782 GU Practitioner - Physician Assistant 4981194537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Morehouse School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Conference Corp of SdaGroup PAC ID 6608777628, 52 clinicians

Practice addresses (Care Compare)

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-151GUMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
General Conference Corp of Sda CurrentSince Sep 1, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rachel.magistre-legend.1@31775.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1013117175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-646-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-646-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGISTRE-LEGEND",
        "first_name": "RACHEL",
        "middle_name": "IVY GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GU",
            "license": "PA-151",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "THOMAS",
            "middle_name": "MAGISTRE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.