Individual provider Active NPI

Joseph Griffin Rebideaux, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Washington, DC
National Provider Identifier
1548867948
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024180223 Issued in VA
Practice address
110 Irving St NW
Washington, DC 20010-3017
Phone
(202) 877-7000
NPI assigned
Oct 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 838829 NV
Adult Health Nurse Practitioner 363LA2200X 838829 NV
Acute Care Nurse Practitioner 363LA2100X 0024180223 VA Primary
Gerontology Nurse Practitioner 363LG0600X 838829 NV

Addresses

Primary practice location

110 Irving St NW
Washington, DC 20010-3017

Mailing address

1155 Mill St Ms M14
Reno, NV 89502-1576
Phone (775) 982-5262

Other practice location 1

1155 Mill St MS W14
Reno, NV 89502-1576
Phone (775) 982-7878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20210617001086 NV Practitioner - Nurse Practitioner 1052711744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024180223VAMDAcute Care Nurse Practitioner
838829NVMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Jun 10, 2021 Accepting new patients
Community Care Services LLC CurrentSince Jun 10, 2021 Accepting new patients
Community Care Services LLC Current Accepting new patients
Community Care Services LLC Past Accepting new patients
Community Care Services LLC Past Accepting new patients

Locations

1495 Mill St
Reno, NV 89502
Phone (775) 982-3500

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

1155 Mill St
#W14
Reno, NV 89502
Phone (775) 982-2125

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

75 Pringle Way
Ste 401
Reno, NV 89502
Phone (775) 982-2970

Interoperability endpoints

  • Direct secure messaging: jrebideaux172260@direct.renown.org

Organizations & group practices 5

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 4

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": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1548867948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST MS M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Mill St MS W14",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REBIDEAUX",
        "first_name": "JOSEPH",
        "middle_name": "GRIFFIN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-08",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "838829",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NV",
            "license": "838829",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024180223",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "838829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.