Individual provider Active NPI

Rebecca F Nishimoto, PA-C

  • Surgical Physician Assistant
  • Highland Park, IL
National Provider Identifier
1073624664
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085002085 Issued in IL
Practice address
777 Park Ave W
Highland Park, IL 60035-2433
Phone
(847) 926-5844
NPI assigned
Aug 31, 2006
Last updated
Mar 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002085 IL
Surgical Physician Assistant 363AS0400X 085002085 IL Primary
Emergency Medicine Physician 207P00000X 085002085 IL

Addresses

Primary practice location

777 Park Ave W
Highland Park, IL 60035-2433

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 982-6710

Other identifiers 1

IdentifierTypeStateIssuer
P00417652OtherRAILROAD MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040119000249 IL Practitioner - Physician Assistant 7113828500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

777 Park Ave W
Highland Park, IL 60035-2433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085002085ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 26, 2013 Accepting new patients
Cep America - Illinois, LLP Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Loren S Schechter MD SC LTD Past Accepting new patients
Skokie Emergency Services, LLC Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2800 N Sheridan Rd
Ste 60
Chicago, IL 60657
Phone (773) 525-8846

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

777 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3744

777 Park Ave W
Ste B131A
Highland Park, IL 60035
Phone (847) 926-5844

1225 W Lake St
Melrose Park, IL 60160
Phone (708) 681-3000

9600 Gross Point Rd
Skokie, IL 60076
Phone (847) 677-9600

Organizations & group practices 7

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1073624664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433",
            "telephone_number": "847-926-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMOTO",
        "first_name": "REBECCA",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002085",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085002085",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "085002085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P00417652",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.