Individual provider Active NPI

Rebecca Stworzyjanek, PA

  • Physician Assistant
  • Carlsbad, CA
National Provider Identifier
1710113873
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55111 Issued in CA
Practice address
2176 Salk Ave
Carlsbad, CA 92008
Phone
(760) 901-5100
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013245 NY
Physician Assistant 363A00000X PA55111 CA Primary

Addresses

Primary practice location

2176 Salk Ave
Carlsbad, CA 92008

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 901-5100

Other practice location 1

6 Technology Dr
Suite 100
East Setauket, NY 11733-4079
Phone (631) 689-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55111CAMDDentist
356HIMDPhysical Therapist
PA55111CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Medical Group, Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1710113873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-901-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 SALK AVE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92008",
            "telephone_number": "760-901-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Technology Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "East Setauket",
            "state": "NY",
            "postal_code": "117334079",
            "country_code": "US",
            "telephone_number": "631-689-6698",
            "fax_number": "631-751-5548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STWORZYJANEK",
        "first_name": "REBECCA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013245",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.