Individual provider Active NPI

Rebecca Busenbark, PT, DPT

  • Physical Therapist
  • South Bend, IN
National Provider Identifier
1265861231
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013335A Issued in IN
Practice address
401 E Colfax Ave Ste 102
South Bend, IN 46617
Phone
(574) 234-1059
NPI assigned
Nov 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05013335A IN Primary
Physical Therapist 225100000X 10636PT AZ

Addresses

Primary practice location

401 E Colfax Ave Ste 102
South Bend, IN 46617

Mailing address

PO Box 643407
Pittsburgh, PA 15264-3407
Phone (800) 721-8202

Other names 1

  • Dr. Rebecca Holtz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210113000735 IN Practitioner - Physical Therapist in Private Practice 6305259326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rci (WRS) LLCGroup PAC ID 5092624510, 325 clinicians

Practice addresses (Care Compare)

12788 Adams Rd
Granger, IN 46530-7893
Phone (574) 271-1434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10636PTAZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC CurrentSince Dec 1, 2020 Accepting new patients
Rci (WRS), LLC CurrentSince Dec 1, 2020 Accepting new patients
Rci (WRS), LLC. Physical Therapist Current Accepting new patients

Locations

12788 State Road 23
Granger, IN 46530
Phone (574) 271-1434

300 S Saint Louis Blvd
Ste 203
South Bend, IN 46617
Phone (574) 234-1059

401 E Colfax Ave
Ste 102
South Bend, IN 46617
Phone (574) 234-1059

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1265861231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643407",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152643407",
            "telephone_number": "800-721-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E COLFAX AVE STE 102",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46617",
            "telephone_number": "574-234-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSENBARK",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-11",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013335A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10636PT",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "HOLTZ",
            "prefix": "DR.",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.