Individual provider Active NPI

Rebecca A. La Rock, PAC

  • Physician Assistant
  • Waukesha, WI
National Provider Identifier
1245609742
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3710 Issued in WI
Practice address
1111 Delafield Street
Suite 311
Waukesha, WI 53188
Phone
(262) 544-4411
Fax
(262) 650-3856
NPI assigned
Sep 15, 2015
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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 3710 WI Primary

Addresses

Primary practice location

1111 Delafield Street
Suite 311
Waukesha, WI 53188

Mailing address

1260 Sentry Dr
Ste 140
Waukesha, WI 53186-5990
Phone (262) 524-1024

Other names 1

  • Rebecca A. Michalek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20161114000297 WI Practitioner - Physician Assistant 8426337528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Medical Group Waukesha SCGroup PAC ID 1153670054, 43 clinicians

Practice addresses (Care Compare)

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-0620

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-5400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates SC CurrentSince Jan 9, 2021 Accepting new patients
Moreland OB-GYN Associates S C PastSince Jul 31, 1993 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1260 Sentry Dr
Ste 140
Waukesha, WI 53186
Phone 2625241024300

Interoperability endpoints

  • Direct secure messaging: rlarock46147@direct.phci.org

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 1

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": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1245609742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 SENTRY DR",
            "address_2": "STE 140",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865990",
            "telephone_number": "262-524-1024",
            "fax_number": "262-524-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD STREET",
            "address_2": "SUITE 311",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-544-4411",
            "fax_number": "262-650-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA ROCK",
        "first_name": "REBECCA",
        "middle_name": "A.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "MICHALEK",
            "middle_name": "A.",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.