Individual provider Active NPI

Rebecca Soffian, PA

  • Physician Assistant
  • Marietta, OH
National Provider Identifier
1629246293
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.002683RX Issued in OH
Practice address
800 Wayne St Ste 112
Marietta, OH 45750-3309
Phone
(740) 373-4288
Fax
(740) 373-4254
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 01334 WV
Physician Assistant 363A00000X 50.002683RX OH Primary

Addresses

Primary practice location

800 Wayne St Ste 112
Marietta, OH 45750-3309

Mailing address

PO Box 449
Marietta, OH 45750-0449

Other identifiers 1

IdentifierTypeStateIssuer
0070663MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rebecca.soffian@mmhs.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090605000383 OH Practitioner - Physician Assistant 5698852416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-1400

800 Wayne St
Marietta, OH 45750-3309

Hospital & facility affiliations

  • Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147
  • Selby General Hospital Hospital, Marietta, OH, CCN 361319

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.002683RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Memorial Hospital CurrentSince Oct 1, 2010 Accepting new patients

Locations

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

701 Hildreth Ln
Marietta, OH 45750
Phone (740) 371-7194

800 Wayne St
Ste 112
Marietta, OH 45750
Phone (740) 373-4288

400 Matthew St
Ste 101
Marietta, OH 45750
Phone (740) 568-4150

Organizations & group practices 2

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 2

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": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1629246293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WAYNE ST STE 112",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503309",
            "telephone_number": "740-373-4288",
            "fax_number": "740-373-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFFIAN",
        "first_name": "REBECCA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "01334",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002683RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070663",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.soffian@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "800 Wayne St Ste 112",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457503309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.