Mark Rebolos, M.D. , F.A.C.O.G

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

298180 Issued in NY

Practice address

5645 Main St Dept of
Flushing, NY 11355-5045

Phone

(718) 670-2000

NPI assigned

Jun 26, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Obstetrics/Gynecology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St John'S Medical Services PCGroup PAC ID 1850314865, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St John'S Episcopal Hospital at South Shore Hospital, Far Rockaway, NY, CCN 330395

Merit-based Incentive Payment System (MIPS)

Final score

97.83 of 100Reported as group

Quality

78.68

Promoting interoperability

98

Improvement activities

40

Cost

82.43

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

85.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: mark.rebolos.1@14448.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

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.

• St John'S Medical Services PC

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1023042173
  Medicare reassignment Care Compare group NPD
• New York Queens Medicine and Surgery, P.C.

  • Pediatrics Physician
  • Fresh Meadows, NY
  • NPI 1003114851
  Medicare reassignment NPD
• New York Queens Medicine and Surgery, P.C.

  • Multi-Specialty Clinic/Center
  • Flushing, NY
  • NPI 1740792233
  NPD
• Episcopal Health Services Inc

  • General Acute Care Hospital
  • Far Rockaway, NY
  • NPI 1346274537
  NPD (past)
• Episcopal Health Services Inc

  • Community/Retail Pharmacy
  • Far Rockaway, NY
  • NPI 1689151201
  NPD (past)

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1255746368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-630-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST DEPT OF",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBOLOS",
        "first_name": "MARK",
        "credential": "M.D. , F.A.C.O.G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "298180",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St Dept Of",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St Dept Of",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mar9413@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "5645 Main St Dept Of",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• RC Recovery Inc
• RCP Physical Therapy P.C.
• RDS Dental, PLLC
• Ready Set Go Rehabilitation and Development LLC
• Marina Rebchinsky, MD
• Red Apple Medicine P.L.L.C.
• Red Sun Home Care Inc.
• Red Sun Home Care Inc.
• Red Sun Home Care Inc.
• Redcore Physical Therapy and Rehabilitation LLC

• Obstetrics & Gynecology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.