Individual provider Active NPI

Rebecca Giuditta Lichtenwalner, PA-C

  • Physician Assistant
  • Danbury, CT
National Provider Identifier
1235493859
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2764 Issued in CT
Practice address
2 Riverview Dr
Danbury, CT 06810-6268
Phone
(203) 797-1500
Fax
(203) 730-9507
NPI assigned
Jun 28, 2012
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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 2764 CT Primary
Physician Assistant 363A00000X 25MP00328700 NJ

Addresses

Primary practice location

2 Riverview Dr
Danbury, CT 06810-6268

Mailing address

2 Riverview Dr
Danbury, CT 06810-6268
Phone (203) 797-1500

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120827000662 CT Practitioner - Physician Assistant 1951558956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthoconnecticut PLLCGroup PAC ID 1850369018, 82 clinicians

Practice addresses (Care Compare)

131 Kent Rd
New Milford, CT 06776-3485
Phone (860) 355-8000

2 Riverview Dr
Danbury, CT 06810-6268

90 Grove St
Suite 107
Ridgefield, CT 06877-4129
Phone (203) 797-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00328700NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoconnecticut, PLLC CurrentSince Jun 6, 2024 Accepting new patients
Orthoconnecticut, PLLC CurrentSince Jun 6, 2024 Accepting new patients
Orthoconnecticut, PLLC Past Accepting new patients

Locations

2 Riverview Dr
Danbury, CT 06810
Phone (203) 798-9702

131 Kent Rd
New Milford, CT 06776
Phone (860) 350-3330

90 Grove St
Ste 107
Ridgefield, CT 06877
Phone (203) 431-6515

900 Main St S
Bldg 3
Southbury, CT 06488

45 Danbury Rd
Ste 100
Wilton, CT 06897

Interoperability endpoints

  • Direct secure messaging: rlichtenwalner@doa1744.srs-direct.com

Organizations & group practices 4

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 2

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1235493859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RIVERVIEW DR",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106268",
            "telephone_number": "203-797-1500",
            "fax_number": "203-730-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RIVERVIEW DR",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106268",
            "telephone_number": "203-797-1500",
            "fax_number": "203-730-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENWALNER",
        "first_name": "REBECCA",
        "middle_name": "GIUDITTA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "2764",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00328700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.