Individual provider Active NPI

Rebecca Ellwood, PA-C

  • Medical Physician Assistant
  • Albany, NY
National Provider Identifier
1518100403
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
013029 Issued in NY
Practice address
1365 Washington Ave Ste 300
Albany, NY 12206-1098
Phone
(518) 489-4704
Fax
(518) 810-0043
NPI assigned
Apr 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 013029 NY Primary

Addresses

Primary practice location

1365 Washington Ave Ste 300
Albany, NY 12206-1098

Mailing address

1365 Washington Ave Ste 300
Albany, NY 12206-1098
Phone (518) 489-4704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130415000468 NY Practitioner - Physician Assistant 5991941064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

220 Washington Ave Ext
Albany, NY 12203-5316
Phone (518) 262-9600

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3277

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013029NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College Past Accepting new patients

Locations

220 Washington Avenue Ext
Albany, NY 12203
Phone (518) 264-4460

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

1365 Washington Ave
Ste 300
Albany, NY 12206
Phone (518) 489-4704

Organizations & group practices 3

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": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1518100403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE STE 300",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061098",
            "telephone_number": "518-489-4704",
            "fax_number": "518-810-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE STE 300",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061098",
            "telephone_number": "518-489-4704",
            "fax_number": "518-810-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLWOOD",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.