Active NPI
Egbert Rebeiro, M.D.
- Surgery Physician
- Martin, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- E-6965
- Practice address
- 143 Kennedy Dr
Suite B
Martin, TN 38237-3309 - Phone
- (731) 587-3030
- Fax
- (731) 587-3032
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 24570 | KY | |
| Emergency Medicine Physician | 207P00000X | E-6965 | AR | |
| Surgery Physician | 208600000X | MD 12630 | TN | |
| Surgical Oncology Physician | 2086X0206X | MD-12630 | TN | |
| Surgery Physician | 208600000X | E-6965 | AR | Primary |
Addresses
Primary practice location
143 Kennedy Dr
Suite B
Martin, TN 38237-3309
Mailing address
143 Kennedy Dr
Suite B
Martin, TN 38237-3309
Phone (731) 587-3030
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4082293 | Other | TN | AETNA |
| 3325272 | Medicaid | TN | |
| 3831541 | Other | TN | CIGNA |
| 156656 | Other | TN | BHP |
| 4092729 | Other | TN | BCBS |
| 64771579 | Other | KY | KY MEDICAID |
| 32638 | Other | TN | TLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
208 N 5TH St
Blytheville, AR 72315-2712
Phone (870) 776-1477
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 12630 | TN | MD | Surgery Physician |
| MD-12630 | TN | MD | Surgical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Care Consultants of Fordyce LLC | Current | Accepting new patients | |
| Concord Medical Group of Texas PLLC | Emergency Medicine | Current | Accepting new patients |
| Sark Opl | Current | Accepting new patients | |
| St Marys Physician Services, LLC | Current | Accepting new patients | |
| East Arkansas Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| Ess of McGehee LLC | Emergency Medicine | Current | Accepting new patients |
| Ess of Fordyce LLC | Emergency Medicine | Current | Accepting new patients |
| Concord Medical Group PLLC | Emergency Medicine | Current | Accepting new patients |
| East Arkansas Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| St Mary's Physician Services LLC | Current | Accepting new patients | |
| Surgical Specialists P C | Surgery | Current | Accepting new patients |
| East Arkansas Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| St Marys Physician Services, LLC | Past | Accepting new patients | |
| Martin Clinic Corp | Surgery | Past | Accepting new patients |
Locations
1520 N Division St
Blytheville, AR 72315
Phone (870) 838-7300
1100 Medical Dr
Blytheville, AR 72315
Phone (870) 762-6725
208 N 5th St
Blytheville, AR 72315
Phone (870) 763-2461
201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300
900 S 3rd St
McGehee, AR 71654
Phone (855) 498-6768
611 W Lee Ave
Osceola, AR 72370
Phone (870) 563-7000
1507 Linwood Dr
Paragould, AR 72450
Phone (870) 239-8105
7200 S Hazel St
Pine Bluff, AR 71603
Phone (870) 534-2900
101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345
2000 Holiday Ln
Fulton, KY 42041
Phone (270) 472-2522
905 S Main St
Shattuck, OK 73858
Phone (580) 938-2551
130 E Locust St
Dresden, TN 38225
Phone (731) 364-3196
5001 E Main St
Erin, TN 37061
Phone (336) 944-6420
481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586
101 Highway 431
Martin, TN 38237
Phone (731) 587-3030
143 Kennedy Dr
Ste B
Martin, TN 38237
Phone (731) 587-3030
6584 Poplar Ave
Ste 400
Memphis, TN 38138
Phone (901) 300-6713
17304 Preston Rd
Ste 1400
Dallas, TX 75252
Phone (972) 934-3200
Interoperability endpoints
- erebeiro@yourcarecommunity.org
Organizations & group practices 15
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.
-
- Emergency Medicine Physician
- Blytheville, AR
- NPI 1932442985
-
- Emergency Medicine Physician
- Fordyce, AR
- NPI 1821547977
-
- Emergency Medicine Physician
- McGehee, AR
- NPI 1639822653
-
- Hospitalist Physician
- Fordyce, AR
- NPI 1316497464
-
- General Practice Physician
- Russellville, AR
- NPI 1124084991
-
- Emergency Medicine Physician
- Hope, AR
- NPI 1275774630
-
- Emergency Medicine Physician
- Lubbock, TX
- NPI 1750790762
-
- Emergency Medicine Physician
- Clarksville, AR
- NPI 1609259753
-
- Emergency Medicine Physician
- Paragould, AR
- NPI 1760864953
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Great River Medical Center
- General Acute Care Hospital
- Blytheville, AR
- NPI 1316180748
-
dba Helena Hospital
- Rural Acute Care Hospital
- Helena, AR
- NPI 1154392090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1275583908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 KENNEDY DR",
"address_2": "SUITE B",
"city": "MARTIN",
"state": "TN",
"postal_code": "382373309",
"telephone_number": "731-587-3030",
"fax_number": "731-587-3032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 KENNEDY DR",
"address_2": "SUITE B",
"city": "MARTIN",
"state": "TN",
"postal_code": "382373309",
"telephone_number": "731-587-3030",
"fax_number": "731-587-3032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBEIRO",
"first_name": "EGBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "24570",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AR",
"license": "E-6965",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "MD 12630",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "TN",
"license": "MD-12630",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AR",
"license": "E-6965",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4082293",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3325272",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3831541",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BHP",
"identifier": "156656",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4092729",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KY MEDICAID",
"identifier": "64771579",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TLC",
"identifier": "32638",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Martin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.