Individual provider Active NPI

Rebecca L Kesman, MD

  • Internal Medicine Physician
  • Auburn, MA
National Provider Identifier
1174537161
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
250290 Issued in MA
Practice address
385 Southbridge St
Auburn, MA 01501-2498
Phone
(508) 721-1170
Fax
(508) 832-0859
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 48453 MN
Internal Medicine Physician 207R00000X 2010-01475 NC
Internal Medicine Physician 207R00000X 250290 MA Primary

Addresses

Primary practice location

385 Southbridge St
Auburn, MA 01501-2498

Mailing address

5 Neponset St FL Street2
Worcester, MA 01606-2714
Phone (508) 721-1170

Other identifiers 6

IdentifierTypeStateIssuer
5918008MedicaidNC
P00450113OtherMNRAILROAD MEDICARE
35100500MedicaidWI
ENROLLEDMedicaidIA
043675000MedicaidMN
NC1396MedicaidSC

Other names 1

  • Rebecca L Freitas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20121022000403 MA Practitioner - Internal Medicine 3375546302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Connecticut School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

Hospital & facility affiliations

  • Vna Care Network Home health agency, Worcester, MA, CCN 227098
  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250290MAMDInternal Medicine Physician
48453MNMDInternal Medicine Physician
2010-01475NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

4 Brotherton Way
Auburn, MA 01501
Phone (508) 425-5446

385 Southbridge St
Auburn, MA 01501
Phone (508) 721-1101

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
#2
Worcester, MA 01606

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

Interoperability endpoints

  • Direct secure messaging: rebecca.kesman.npi1174537161.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1174537161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-721-1170",
            "fax_number": "508-832-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 SOUTHBRIDGE ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012498",
            "telephone_number": "508-721-1170",
            "fax_number": "508-832-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESMAN",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "48453",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2010-01475",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "250290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918008",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00450113",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35100500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043675000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1396",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "FREITAS",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn, MA

Sources for this page

Verify at the official NPI Registry.