Individual provider Active NPI

Rebekah Charchenko, CRNA

  • Certified Registered Nurse Anesthetist
  • Bismarck, ND
National Provider Identifier
1033534631
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R45088 Issued in ND
Practice address
900 E Broadway Ave
Bismarck, ND 58501
Phone
(701) 530-7000
NPI assigned
Feb 19, 2014
Last updated
Jul 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R 172352-2 MN
Certified Registered Nurse Anesthetist 367500000X R45088 ND Primary

Addresses

Primary practice location

900 E Broadway Ave
Bismarck, ND 58501

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 2

IdentifierTypeStateIssuer
N725460OtherNDMEDICARE
1473378MedicaidND

Other names 1

  • Rebekah Olson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180420002239 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385868371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R 172352-2MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince May 14, 2018 Accepting new patients
St. Alexius Medical Center CurrentSince May 14, 2018 Accepting new patients

Locations

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Organizations & group practices 2

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 1

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": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1033534631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-530-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARCHENKO",
        "first_name": "REBEKAH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 172352-2",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R45088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N725460",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473378",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "OLSON",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.