Nicholas M Rezek, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004972 Issued in WA

Practice address

400 S 43Rd St
Renton, WA 98055-5714

Phone

(425) 228-3450

NPI assigned

Jan 2, 2006

Last updated

Sep 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Northwest Emergency Physicians LLC

  dba Nep

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370
  NPD
• Lewis County Emergency Physicians

  • Emergency Medicine Physician
  • Centralia, WA
  • NPI 1174555684
  NPD (past)
• Thurston Emergency Group a Professional LLC

  • Emergency Medicine Physician
  • Olympia, WA
  • NPI 1558526756
  NPD (past)

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1356329221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25246 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731252",
            "telephone_number": "425-656-4255",
            "fax_number": "425-656-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZEK",
        "first_name": "NICHOLAS",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-02",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "3075RE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8442725",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0214542",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eunice Margarita Reyes-Diaz, MA
• Reyjines Haven Afh LLC
• Antonio Reyna, MA
• Robert Reynolds
• Sabrina Lynn Reynolds, LMP
• Peter C. Rhee, PA-C
• Rhema Aesthetics and Wellness PLLC (Rhema Medical Center)
• Rhema Healing & Wound Care LLC (Rhema Specialty Care LLC)
• Alana L Rhodes, LMT
• Mary G Ricci, RD

• Physician Assistant in Renton, WA
• Providers in Renton, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.