NPIMap

Individual provider Active NPI

Rene L Wells, PA-C

  • Physician Assistant
  • Du Bois, PA
National Provider Identifier
1104991777
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051791 Issued in PA
Practice address
90 Beaver Dr BLDG C
Du Bois, PA 15801-2440
Phone
(814) 317-2273
NPI assigned
Nov 21, 2006
Last updated
Apr 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051791 PA Primary
Family Medicine Physician 207Q00000X OA002592 PA

Addresses

Primary practice location

90 Beaver Dr BLDG C
Du Bois, PA 15801-2440

Mailing address

90 Beaver Dr BLDG C
Du Bois, PA 15801-2440
Phone (814) 317-2273

Other identifiers 4

IdentifierTypeStateIssuer
61854OtherPAGEISINGER
0018251700002MedicaidPA
2078210OtherPABLUE SHIELD
V0075DOtherPAUPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000621 PA Practitioner - Physician Assistant 2567427180 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

100 Hospital Ave
Du Bois, PA 15801-1440

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

761 Johnsonburg Rd
Saint Marys, PA 15857-3480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051791PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookville Hospital Family Medicine CurrentSince Feb 27, 2018 Accepting new patients
Dubois Regional Medical Center Family Medicine CurrentSince Feb 19, 2018 Accepting new patients
Dubois Regional Medical Center CurrentSince Feb 19, 2018 Accepting new patients
Brookville Hospital Family Medicine CurrentSince Feb 27, 2018 Accepting new patients
Dubois Regional Medical Center Family Medicine Past Accepting new patients

Locations

100 Hospital Rd
Brookville, PA 15825
Phone (814) 849-1408

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

145 Hospital Ave
Ste 102
Dubois, PA 15801
Phone (814) 375-6510

90 Beaver Dr
Ste C
Dubois, PA 15801
Phone (814) 317-2273

761 Johnsonburg Rd
Ste 310
Saint Marys, PA 15857
Phone (814) 788-8577

Interoperability endpoints

  • Direct secure messaging: rlwells@1285.direct.myezyaccess.com

Organizations & group practices 6

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1104991777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BEAVER DR BLDG C",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012440",
            "telephone_number": "814-317-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BEAVER DR BLDG C",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012440",
            "telephone_number": "814-317-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "RENE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051791",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OA002592",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "61854",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018251700002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "2078210",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "V0075D",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.