Individual provider Active NPI

Rebekah Elise Nelson, PA

  • Surgical Physician Assistant
  • Parker, CO
National Provider Identifier
1588221014
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
9399 Crown Crest Blvd Ste 220
Parker, CO 80138-8508
Phone
(303) 805-1855
Fax
(303) 805-4421
NPI assigned
May 20, 2019
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

9399 Crown Crest Blvd Ste 220
Parker, CO 80138-8508

Mailing address

9399 Crown Crest Blvd Ste 220
Parker, CO 80138-8508
Phone (303) 805-1855

Other identifiers 1

IdentifierTypeStateIssuer
PA.0006410OtherCOCO MED LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200929002303 CO Practitioner - Physician Assistant 8022437771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
54.48 of 100Reported as group
Quality
58.76
Promoting interoperability
0
Improvement activities
30
Cost
77.1

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chris B Winter MD PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1588221014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9399 CROWN CREST BLVD STE 220",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388508",
            "telephone_number": "303-805-1855",
            "fax_number": "303-805-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9399 CROWN CREST BLVD STE 220",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388508",
            "telephone_number": "303-805-1855",
            "fax_number": "303-805-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "REBEKAH",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO MED LICENSE",
            "identifier": "PA.0006410",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.