Rebecca Ellen Veasey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.001046 Issued in IL

Practice address

856 North Convent
Suite C
Bourbonnais, IL 60914-0000

Phone

(815) 936-5167

Fax

(630) 914-2469

NPI assigned

May 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Rebecca Ellen Beversdorf Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155
• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Prime Healthcare Illinois Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1023837689
  Medicare reassignment Care Compare group
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Presence Service Corporation

  dba Presence Medical Group

  • Family Medicine Physician
  • Bolingbrook, IL
  • NPI 1831204536
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• St Marys Hospital - Kankakee LLC

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1467290809
  Care Compare affiliation

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1700832326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 REMINGTON BLVD",
            "address_2": "SUITE 100 (ATTN: MELVONNE JONES)",
            "city": "BOLINGBROCK",
            "state": "IL",
            "postal_code": "604400000",
            "telephone_number": "630-914-2417",
            "fax_number": "630-914-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 NORTH CONVENT",
            "address_2": "SUITE C",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609140000",
            "telephone_number": "815-936-5167",
            "fax_number": "630-914-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEASEY",
        "first_name": "REBECCA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001046",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.001046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085001046",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4622394",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BEVERSDORF",
            "middle_name": "ELLEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Vander Veer, PSYD
• Salil R Vasanwala, M.D.
• Brian David Vaughn
• Polly Marie Vaughn
• Victor Manuel Vazquez Cervantes, PHARMD
• Cole Jonathan Verbrugge, DC
• Mark Vidas, O.D.
• Edwin Viglia III, LPC
• Joel P Villegas, MD
• Vishwam, Inc (Bourbonnais Pharmacy)

• Physician Assistant in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.