Evan T Rebillot, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1300 York Ave
New York, NY 10065-4805

Phone

(845) 926-4968

NPI assigned

Jan 22, 2016

Last updated

Jan 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: evr9036@direct.nyp.org

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1730546649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BUSHWICK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063729",
            "telephone_number": "330-806-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654805",
            "telephone_number": "845-926-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBILLOT",
        "first_name": "EVAN",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arielle Desiree Rebelo
• Emily Irene Rebenstock
• Kayla Rebetti
• Max Ryan Rebhun, DPT
• Theodore Rebich Jr., PH.D. D.M.D. M.P.H.
• Victoria Rebimbas
• Sabina Rebis, MD
• Rebound New York Medical, PC (Scott Bienenfeld, M.D.)
• Pedro Recabal Guiraldes, M.D.
• Dauren Caayupan Recalde

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.