Individual provider Active NPI

Joseph Andrew Nebeker, PA

  • Physician Assistant
  • Ellensburg, WA
National Provider Identifier
1386374619
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 E Jackson Ave
Ellensburg, WA 98926-3692
Phone
(509) 933-8777
NPI assigned
Jun 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

100 E Jackson Ave
Ellensburg, WA 98926-3692

Mailing address

921 S 8TH Ave Stop 8253
Pocatello, ID 83209-0002
Phone (208) 282-4726

Other names 1

  • Joey Andrew Nebeker Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110000403 WA Practitioner - Physician Assistant 4789054693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 E Jackson Ave
Ellensburg, WA 98926-3692
Phone (509) 933-8777

603 S Chestnut St
Ellensburg, WA 98926-3875
Phone (509) 962-9841

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.91 of 100Reported as group
Quality
66.6
Promoting interoperability
100
Improvement activities
40
Cost
69.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas County Public Hospital Dist 1 CurrentSince Feb 20, 2023 Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Feb 20, 2023 Accepting new patients
Kittitas County Public Hospital Dist 1 Past Accepting new patients

Locations

100 E Jackson Ave
Ellensburg, WA 98926
Phone (509) 574-6000

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

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.

Hospital & facility affiliations 3

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1386374619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE STOP 8253",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090002",
            "telephone_number": "208-282-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E JACKSON AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263692",
            "telephone_number": "509-933-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBEKER",
        "first_name": "JOSEPH",
        "middle_name": "ANDREW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOEY",
            "last_name": "NEBEKER",
            "middle_name": "ANDREW",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.