Rebecca M. Burgoon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.003035 Issued in OH

Practice address

5700 Monroe St Unit 103
Sylvania, OH 43560-2771

Phone

(419) 843-7996

Fax

(419) 841-7704

NPI assigned

Apr 15, 2010

Last updated

Nov 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, MI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rburgoon22194@direct.promedica.org

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.

• Mercy Health Physicians-North LLC

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1609000769

  MI

  Medicare reassignment NPD
• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150

  Physician Assistant

  Medicare reassignment NPD
• Mercy Emergency Care Services, Inc.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1477957819
  Medicare reassignment
• Mercy Health Physicians - North, LLC

  dba Mercy Health - Perrysburg Podiatry

  • Customized Equipment (DME)
  • Perrysburg, OH
  • NPI 1992358766
  NPD
• Promedica Central Physicians

  dba ProMedica Physicians Durable Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• Aspen Medical Partners LLC

  • Family Medicine Physician
  • Lambertville, MI
  • NPI 1992788251
  NPD
• Alternative Residences Two Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Massillon, OH
  • NPI 1124235122
  NPD (past)
• Alternative Residencestwo Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Massillon, OH
  • NPI 1750590816
  NPD (past)
• Observation Physicians of Northwest Ohio LLC

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1700462967
  NPD (past)
• Res-Care Ohio, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Wellington, OH
  • NPI 1316335136
  NPD (past)

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1013233055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "419-843-7996",
            "fax_number": "419-841-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MONROE ST UNIT 103",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602771",
            "telephone_number": "419-843-7996",
            "fax_number": "419-841-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOON",
        "first_name": "REBECCA",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-11-03",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007063",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103145",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rburgoon22194@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Brunk, FNP-C
• Brigitte Budion, MS, RDN, CDN, LDN
• Simone Buford
• Megan R Bunton, CCC/SLP
• Jack Christopher Burg
• Lisa L Burke, D.O.
• Melissa R Burke, SLP
• Craig G Burkhart, M.D.
• Jessica Abbate Burns, M.D.
• Allison Ann Butler, PHARMD

• Physician Assistant in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.