Individual provider Active NPI

Rebecca Faicco, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Selden, NY
National Provider Identifier
1720313414
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
23-013506 Issued in NY
Practice address
239 Middle Country Rd
Selden, NY 11784-2516
Phone
(631) 696-5437
NPI assigned
Oct 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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 23-013506 NY Primary

Addresses

Primary practice location

239 Middle Country Rd
Selden, NY 11784-2516

Mailing address

500 Raft Ave
Holbrook, NY 11741-5912

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23-013506NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Physicians Group, PLLC Past Accepting new patients
PM Pediatrics PC Past Accepting new patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics of Selden Past Accepting new patients
Night Lite Pediatric Center, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rebecca.allenbrand@pmuc.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1720313414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RAFT AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MIDDLE COUNTRY RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842516",
            "telephone_number": "631-696-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAICCO",
        "first_name": "REBECCA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23-013506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selden, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.