Individual provider Active NPI

Erin I Rebelo, P.A.

  • Surgical Physician Assistant
  • Boston, MA
National Provider Identifier
1780860775
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
AP2445 Issued in MA
Practice address
750 Washington St
Boston, MA 02111-1526
Phone
(617) 636-5858
Fax
(617) 636-7587
NPI assigned
Jan 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X AP2445 MA Primary

Addresses

Primary practice location

750 Washington St
Boston, MA 02111-1526

Mailing address

750 Washington St
Boston, MA 02111-1526
Phone (617) 636-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220902002446 MA Practitioner - Physician Assistant 9335523737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

114 N Beacon St
Suite 116
Brighton, MA 02135-2011
Phone (781) 983-9088

116 N Beacon St
Brighton, MA 02135-2011
Phone (617) 783-5200

330 Brookline Ave
Boston, MA 02215-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP2445MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 20, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 20, 2022 Accepting new patients

Locations

750 Washington St
Boston, MA 02111
Phone (617) 636-4600

247 Station Dr
Ste NW1
Westwood, MA 02090
Phone (617) 754-1015

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1780860775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-5858",
            "fax_number": "617-636-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-5858",
            "fax_number": "617-636-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBELO",
        "first_name": "ERIN",
        "middle_name": "I",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "AP2445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.