Individual provider Active NPI

Rebekah C Medeiros, NP

  • Family Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1386398535
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.012340 Issued in CT
Practice address
55 Park St
New Haven, CT 06511-5474
Phone
(203) 200-2486
NPI assigned
Feb 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 10.201037 CT
Family Nurse Practitioner 363LF0000X APRN03911 RI
Family Nurse Practitioner 363LF0000X 12.012340 CT Primary
Registered Nurse 163W00000X RN63513 RI

Addresses

Primary practice location

55 Park St
New Haven, CT 06511-5474

Mailing address

55 Park St
New Haven, CT 06511-5474

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20240722001239 RI Practitioner - Nurse Practitioner 5193261659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5435

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10.201037CTMDRegistered Nurse
RN63513RIMDRegistered Nurse
12.012340CTMDFamily Nurse Practitioner
APRN03911RIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince May 11, 2024 Accepting new patients
Rhode Island Hospital CurrentSince May 11, 2024 Accepting new patients
Yale University Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
#122
Providence, RI 02903
Phone (401) 444-6195

593 Eddy St
Providence, RI 02903

Organizations & group practices 4

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 7

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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1386398535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115474",
            "telephone_number": "203-200-2486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5435",
            "fax_number": "401-444-8301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "REBEKAH",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "10.201037",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN03911",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.012340",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN63513",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.