Individual provider Active NPI

Rebekah Mickles, CRNA

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1619351020
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN597295 Issued in PA
Practice address
34TH Street and Civic Center Boulevard
Suite 9329
Philadelphia, PA 19104-4399
Phone
(215) 590-1858
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN597295 PA Primary

Addresses

Primary practice location

34TH Street and Civic Center Boulevard
Suite 9329
Philadelphia, PA 19104-4399

Mailing address

100 E Penn SQ
The Wanamaker Building, 9TH Floor, North
Philadelphia, PA 19107-3323
Phone (267) 425-9320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816000551 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880909464 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN597295PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
United Anesthesia Services PC Nurse Anesthetist, Certified Registered CurrentSince Nov 18, 2025 Accepting new patients
Children's Anesthesiology Associates, LTD CurrentSince Jul 13, 2016 Accepting new patients
Children's Anesthesiology Associates, LTD CurrentSince Jul 13, 2016 Accepting new patients
Associates in Anesthesia, Inc. CurrentSince Nov 11, 2025 Accepting new patients
Associates in Anesthesia Past Accepting new patients

Locations

1212 Baltimore Pike
Ste 200
Chadds Ford, PA 19317
Phone (610) 874-4147

30 Medical Center Blvd
Ste 305
Chester, PA 19013
Phone (610) 619-7411

3 Crescent Dr
Ste 310
Philadelphia, PA 19112
Phone (267) 419-3600

324 S 34th St
Ste 9329
Philadelphia, PA 19104
Phone (215) 590-1867

100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538

3401 Civic Center Blvd
Ste 9329
Philadelphia, PA 19104
Phone (267) 425-9300

744 Lancaster Ave
Wayne, PA 19087
Phone (215) 244-7400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

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, 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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1619351020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "THE WANAMAKER BUILDING, 9TH FLOOR, NORTH",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH STREET AND CIVIC CENTER BOULEVARD",
            "address_2": "SUITE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLES",
        "first_name": "REBEKAH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN597295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.