Individual provider Active NPI

Egbert Rebeiro, M.D.

  • Surgery Physician
  • Martin, TN
National Provider Identifier
1275583908
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E-6965 Issued in AR
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

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4082293OtherTNAETNA
3325272MedicaidTN
3831541OtherTNCIGNA
156656OtherTNBHP
4092729OtherTNBCBS
64771579OtherKYKY MEDICAID
32638OtherTNTLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041207000166 TN Practitioner - General SurgeryPractitioner - Surgical OncologyPractitioner - Emergency Medicine 0547225518 Reassigns benefits to 3 organizations
I20110920000510 AR Practitioner - General SurgeryPractitioner - Emergency Medicine 0547225518 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Emergency Medicine
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

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 12630TNMDSurgery Physician
MD-12630TNMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Care Consultants of Fordyce LLC CurrentSince Oct 25, 2023 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
Sark Opl CurrentSince Mar 1, 2025 Accepting new patients
St Marys Physician Services, LLC CurrentSince Jun 28, 2024 Accepting new patients
East Arkansas Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
Ess of McGehee LLC Emergency Medicine CurrentSince Oct 25, 2023 Accepting new patients
Ess of Fordyce LLC Emergency Medicine CurrentSince Oct 25, 2023 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
East Arkansas Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
St Mary's Physician Services LLC CurrentSince Jun 28, 2024 Accepting new patients
Surgical Specialists P C Surgery CurrentSince Aug 30, 2004 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

  • Direct secure messaging: 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.

View all 15

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": "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

Verify at the official NPI Registry.