Rachel Brucas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.006005 Issued in IL

Practice address

9760 S Kedzie Ave
Evergreen Park, IL 60805-3109

Phone

(708) 423-6209

NPI assigned

Nov 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rachel Mortell Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rachel.brucas.1@27901.direct.athenahealth.com

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.

• Evergreen Care Center LTD

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1447449616
  Medicare reassignment
• Park Primary Care LTD

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1891984068
  Medicare reassignment
• The Headache Lab

  • General Practice Physician
  • Evergreen Park, IL
  • NPI 1801782057
  NPD

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1457894768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053109",
            "telephone_number": "708-423-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053109",
            "telephone_number": "708-423-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCAS",
        "first_name": "RACHEL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "MORTELL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer T Brennan, DPT
• Danielle Peyton Brewer
• Madison Brewster, DMD
• Deona Brooks, LPC
• Olivia Brooks
• Tashica Bruce, FNP
• Cha-Ga Bullock, FNP-BC
• Thomas Bump, M.D.
• Jenifer Burgess, LCSW
• John H Burke, M.D.

• Physician Assistant in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.