Individual provider Active NPI

Rebecca L Flores, PA

  • Physician Assistant
  • Holyoke, MA
National Provider Identifier
1790769594
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2054 Issued in MA
Practice address
1221 Main St
Holyoke, MA 01040-5311
Phone
(413) 748-9349
Fax
(413) 452-6080
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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 2054 MA Primary

Addresses

Primary practice location

1221 Main St
Holyoke, MA 01040-5311

Mailing address

271 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9349

Other names 1

  • Ms. Rebecca L. Grimshaw Former name

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
I20051214000123 MA Practitioner - Physician Assistant 9133140460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heather Wark MD LLCGroup PAC ID 1850659384, 3 clinicians

Practice addresses (Care Compare)

548 Elm St
Northampton, MA 01060-2832
Phone (413) 586-2832

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2054MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hampden County Physician Associates, LLC. Past Accepting new patients
Hampden County Physician Associates, LLC Past Accepting new patients

Organizations & group practices 4

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 2

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1790769594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 CAREW ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042377",
            "telephone_number": "413-748-9349",
            "fax_number": "413-452-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MAIN ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405311",
            "telephone_number": "413-748-9349",
            "fax_number": "413-452-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "2054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "GRIMSHAW",
            "middle_name": "L.",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.