Individual provider Active NPI

Rebekah Ann Van Someren, NP

  • Gerontology Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1396241253
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11022876 Issued in FL
Practice address
4251 Stack Blvd
Melbourne, FL 32901-8526
Phone
(321) 953-2219
NPI assigned
Mar 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11022876 FL Primary

Addresses

Primary practice location

4251 Stack Blvd
Melbourne, FL 32901-8526

Mailing address

401 N Michigan Ave
Chicago, IL 60611-4255
Phone (872) 231-3074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230319000008 FL Practitioner - Nurse Practitioner 6002280831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Texas Medical School at Houston, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8050 Spyglass Hill Rd
Viera, FL 32940-7983
Phone (201) 654-6397

Merit-based Incentive Payment System (MIPS)

Final score
87.66 of 100Reported as group
Quality
73.72
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
National Health Rehabilitation LLC Physical Medicine & Rehabilitation CurrentSince Nov 23, 2022 Accepting new patients
Ivan N Mefford MD PHD PA PastSince Oct 1, 2019 Accepting new patients

Locations

703 S 29th St
Fort Pierce, FL 34947
Phone (201) 654-3130

1615 Miami Rd
Ft Lauderdale, FL 33316
Phone (954) 523-5673

3033 Sarno Rd
Melbourne, FL 32934
Phone (321) 243-8593

4251 Stack Blvd
Melbourne, FL 32901
Phone (321) 953-2214

12505 NE 16th Ave
North Miami, FL 33161
Phone (305) 891-1210

1515 Port Malabar Blvd NE
Palm Bay, FL 32905
Phone (321) 723-1235

2811 Campus Hill Dr
Tampa, FL 33612
Phone (813) 972-9700

2355 Vidina Dr
Viera, FL 32940
Phone (321) 775-6800

8050 Spyglass Rd
Viera, FL 32940
Phone (321) 752-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1396241253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114255",
            "telephone_number": "872-231-3074",
            "fax_number": "312-635-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 STACK BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018526",
            "telephone_number": "321-953-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SOMEREN",
        "first_name": "REBEKAH",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-31",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11022876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.