Rebecca S Souza, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004607 Issued in WA

Practice address

3726 Broadway
Suite 201
Everett, WA 98201-3787

Phone

(425) 317-9119

NPI assigned

May 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
• Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

Merit-based Incentive Payment System (MIPS)

Final score

85.57 of 100Reported as group

Quality

63.43

Promoting interoperability

98

Improvement activities

40

Cost

77.49

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rsouza2719264@direct.trinity-health.org

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.

• Saint Agnes Medical Foundation

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1558819482
  Medicare reassignment Care Compare group
• Mid-Valley Community Clinic, PLLC

  • Family Medicine Physician
  • Sunnyside, WA
  • NPI 1447203104
  Medicare reassignment
• Swofford & Halma Clinic, Inc. P.S.

  • Family Medicine Physician
  • Sunnyside, WA
  • NPI 1992758486
  Medicare reassignment
• LQMG Medical Group Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1437166360
  NPD
• Providence Health & Services-Wa

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Everett, WA
  • NPI 1033360144
  NPD (past)

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

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Clovis, CA
  • NPI 1316027709
  Care Compare affiliation
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200182400000",
    "number": "1144277724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY",
            "address_2": "SUITE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013787",
            "telephone_number": "425-317-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY",
            "address_2": "SUITE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013787",
            "telephone_number": "425-317-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "REBECCA",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8394785",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA10004607",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRY",
            "identifier": "0181108",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00162972",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Everett, WA
• Providers in Everett, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.