Individual provider Active NPI

Rebecca Divya Jeyaseelan

  • Physical Medicine & Rehabilitation Physician
  • Joplin, MO
National Provider Identifier
1093975294
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2013021428 Issued in MO
Practice address
932 E 34TH St
Joplin, MO 64804-3932
Phone
(417) 347-1111
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X 2013021428 MO Primary

Addresses

Primary practice location

932 E 34TH St
Joplin, MO 64804-3932

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20131009000933 MO Practitioner - Physical Medicine and Rehabilitation 0143454082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System Past Accepting new patients
Freeman-Oak Hill Health System Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1093975294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 E 34TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043932",
            "telephone_number": "417-347-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEYASEELAN",
        "first_name": "REBECCA",
        "middle_name": "DIVYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2013021428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.