Individual provider Active NPI

Rebekah Renee Wickenheiser, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1720215700
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054001 Issued in PA
Practice address
5125 Jonestown Rd Ste 105
Harrisburg, PA 17112-2987
Phone
(717) 943-1566
Fax
(717) 943-1566
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054001 PA Primary

Addresses

Primary practice location

5125 Jonestown Rd Ste 105
Harrisburg, PA 17112-2987

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20091222000264 PA Practitioner - Physician Assistant 5799825899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 S Sporting Hill Rd
Mechanicsburg, PA 17050-3058
Phone (717) 943-1781

1625 Oregon Pike
Lancaster, PA 17601-4335
Phone (717) 925-2995

2960 E Market St
York, PA 17402-2414
Phone (717) 751-2483

5125 Jonestown Rd
Suite 105
Harrisburg, PA 17112-2987
Phone (717) 943-1566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA054001PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Jan 24, 2012 Accepting new patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Jan 24, 2012 Accepting new patients

Locations

5125 Jonestown Rd
Ste 105
Harrisburg, PA 17112
Phone (717) 943-1566

713 Bethlehem Pike
Montgomeryvle, PA 18936
Phone (267) 695-3944

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: paexchange@patientfirstclinics.com

Organizations & group practices 3

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1720215700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 JONESTOWN RD STE 105",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171122987",
            "telephone_number": "717-943-1566",
            "fax_number": "717-943-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKENHEISER",
        "first_name": "REBEKAH",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5125 Jonestown Rd Ste 105",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171122987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.