Individual provider Active NPI

Paul Rebenack, M.D.

  • Obstetrics & Gynecology Physician
  • Jacksonville, FL
National Provider Identifier
1457312738
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME51115 Issued in FL
Practice address
6885 Belfort Oaks PL Ste 300
Jacksonville, FL 32216-6284
Phone
(904) 296-4200
Fax
(904) 296-1040
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME51115 FL Primary

Addresses

Primary practice location

6885 Belfort Oaks PL Ste 300
Jacksonville, FL 32216-6284

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other identifiers 1

IdentifierTypeStateIssuer
046800200MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100513000692 FL Practitioner - Obstetrics/Gynecology 1254414717 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Florida College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

6885 Belfort Oaks PL
Suite 300
Jacksonville, FL 32216-6284
Phone (904) 296-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME51115FLMDObstetrics & Gynecology Physician
51115FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Womens' Health Hospitalists, LLC Obstetrics & Gynecology CurrentSince Mar 1, 2019 Accepting new patients
Women's Care Florida LLC Obstetrics & Gynecology CurrentSince Mar 1, 2019 Accepting new patients

Locations

836 Prudential Dr
Ste 1202
Jacksonville, FL 32207
Phone (904) 208-2550

6885 Belfort Oaks Pl
Ste 300
Jacksonville, FL 32216
Phone (904) 296-4200

2525 Riverside Ave
Jacksonville, FL 32204
Phone (904) 388-0704

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

5002 W Lemon St
Tampa, FL 33609

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

Interoperability endpoints

  • Direct secure messaging: paul.rebenack@wcfnf.eclinicaldirectplus.com

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.

Hospital & facility affiliations 5

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1457312738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6885 BELFORT OAKS PL STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166284",
            "telephone_number": "904-296-4200",
            "fax_number": "904-296-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBENACK",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME51115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046800200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.