Individual provider Active NPI

Rebecca Lynne Baczuk, MD

  • Physical Medicine & Rehabilitation Physician
  • Winter Park, FL
National Provider Identifier
1023093812
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME153039 Issued in FL
Practice address
200 N Lakemont Ave
Winter Park, FL 32792-3273
Phone
(407) 303-1332
Fax
(407) 303-0347
NPI assigned
Dec 14, 2005
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0101236813 VA
Physical Medicine & Rehabilitation Physician 208100000X ME153039 FL Primary

Addresses

Primary practice location

200 N Lakemont Ave
Winter Park, FL 32792-3273

Mailing address

2388 Bays Edge Ave
Virginia Beach, VA 23451
Phone (410) 991-4647

Other practice location 1

2388 Bays Edge Ave
Virginia Beach, VA 23451
Phone (410) 991-4647

Other practice location 2

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Other identifiers 1

IdentifierTypeStateIssuer
113813700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA, FL4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20130306000139 MD Practitioner - Physical Medicine and RehabilitationPractitioner - General Practice 6709031321 Reassigns benefits to 2 organizations
I20161122001711 DC Practitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 6709031321 Reassigns benefits to 1 organization
I20201209001064 VA Practitioner - Physical Medicine and Rehabilitation 6709031321 Reassigns benefits to 1 organization
I20220321002011 FL Practitioner - Physical Medicine and Rehabilitation 6709031321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
George Washington University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101236813VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Nov 6, 2017 Accepting new patients
MNR Industries, LLC CurrentSince Nov 6, 2017 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 28, 2022 Accepting new patients
Danville Physician Practices LLC CurrentSince Jul 25, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 28, 2022 Accepting new patients
MNR Industries, LLC Current Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Danville Physician Practices LLC CurrentSince Jul 25, 2022 Accepting new patients
MNR Industries, LLC CurrentSince Nov 6, 2017 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince May 1, 2023 Accepting new patients
Greensboro Pathology, LLC Current Accepting new patients

Locations

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 401
Orlando, FL 32804

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

2405 York Rd
Ste 201
Timonium, MD 21093
Phone (240) 332-4048

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4
  • Direct secure messaging: rebecca.baczuk.1@19847.direct.athenahealth.com

Organizations & group practices 12

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1023093812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2388 BAYS EDGE AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23451",
            "telephone_number": "410-991-4647",
            "fax_number": "443-458-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N LAKEMONT AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923273",
            "telephone_number": "407-303-1332",
            "fax_number": "407-303-0347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2388 Bays Edge Ave",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "23451",
            "country_code": "US",
            "telephone_number": "410-991-4647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054543",
            "country_code": "US",
            "telephone_number": "863-687-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACZUK",
        "first_name": "REBECCA",
        "middle_name": "LYNNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101236813",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME153039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113813700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.