Individual provider Active NPI

Rebecca Harrica, PA

  • Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1104139435
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014021 Issued in NY
Practice address
211 Church St
Saratoga Springs, NY 12866-1003
Phone
(518) 587-1141
Fax
(518) 587-1152
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014021 NY Primary

Addresses

Primary practice location

211 Church St
Saratoga Springs, NY 12866-1003

Mailing address

454 Maple Ave
Saratoga Springs, NY 12866-5532
Phone (518) 587-1141

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 1, 2023 through Mar 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014021NYMDPhysical Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: rharrica788644@direct.trinity-health.org

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1104139435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 MAPLE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665532",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661003",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRICA",
        "first_name": "REBECCA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.