Gary Prebeck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13669 Issued in MN

Practice address

1200 6TH Ave N
Saint Cloud, MN 56303-2735

Phone

(404) 727-7825

NPI assigned

Sep 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Range Regional Health Services Hospital, Hibbing, MN, CCN 240040
• Olivia Hospital & Clinic Hospital, Olivia, MN, CCN 241306
• Centracare- Rice Memorial Hospital Hospital, Willmar, MN, CCN 240088

Merit-based Incentive Payment System (MIPS)

Final score

96.26 of 100Reported as group

Quality

89.75

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gprebeck2636904@fairview.direct-ci.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.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment Care Compare group
• Healthpartners RC

  • Critical Access Hospital
  • Olivia, MN
  • NPI 1629091871
  Medicare reassignment NPD
• Healthpartners RC

  • Critical Access Hospital Clinic/Center
  • Olivia, MN
  • NPI 1649470782
  Medicare reassignment NPD
• Emergency Physicians Professional Association

  • Emergency Medicine Physician
  • Bloomington, MN
  • NPI 1801871934
  Medicare reassignment
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment
• Mille Lacs Health System

  • Critical Access Hospital
  • Onamia, MN
  • NPI 1548212699
  Medicare reassignment
• Emergency Physicians Professional Association

  • Urgent Care Clinic/Center
  • Golden Valley, MN
  • NPI 1750188488
  NPD
• Fairview Clinics

  • Clinic/Center
  • Bloomington, MN
  • NPI 1134773419
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carris Health LLC

  • Infusion Therapy Clinic/Center
  • Willmar, MN
  • NPI 1124657150

  Hospital

  Care Compare affiliation
• Carris Health LLC

  • General Acute Care Hospital
  • Willmar, MN
  • NPI 1407367030
  Care Compare affiliation
• Healthpartners RC

  • Critical Access Hospital
  • Olivia, MN
  • NPI 1629091871
  Care Compare affiliation
• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  Care Compare affiliation

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1508417924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-3342",
            "fax_number": "320-252-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "404-727-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREBECK",
        "first_name": "GARY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-26",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Pounds, M.S., CCC-SLP
• Lisa Marie Powell, RN
• Juliette Power, MD
• Lisa Marie Powers, MSW LICSW
• Shashi Nmi Prakash, M.D.
• Danielle Precord
• Pregnancy Resource Center
• Annie Preisler, PHARMD
• Premise Health of Minnesota Medical PC
• Premium Medical Supply LLC

• Physician Assistant in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.