Individual provider Active NPI

Hebah Refaat

  • Nurse Practitioner
  • Greeley, CO
National Provider Identifier
1801265350
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
991639 Issued in CO
Practice address
1900 16TH St
Greeley, CO 80631-5114
Phone
(970) 652-2127
Fax
(970) 652-2447
NPI assigned
Sep 15, 2015
Last updated
Sep 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 991639 CO Primary

Addresses

Primary practice location

1900 16TH St
Greeley, CO 80631-5114

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2404

Other practice location 1

1600 Prairie Center Pkwy
Brighton, CO 80601-4006
Phone (970) 405-5504

Other identifiers 1

IdentifierTypeStateIssuer
991639OtherCOCO NP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20151215002246 CO Practitioner - Nurse Practitioner 9931400074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1024 S Lemay Ave
Poudre Valley Hospital
Fort Collins, CO 80524-3929
Phone (970) 495-7000

Merit-based Incentive Payment System (MIPS)

Final score
93.04 of 100Reported as group
Quality
87.35
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
991639COMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of the Rockies, PC CurrentSince Nov 1, 2019 Accepting new patients
Emergency Physicians of the Rockies, PC CurrentSince Nov 1, 2019 Accepting new patients
Brighton Community Emergency Physicians Lpa CurrentSince Nov 3, 2015 Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

6906 W 10th St
Greeley, CO 80634
Phone (970) 392-4320

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1801265350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-652-2127",
            "fax_number": "970-652-2447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Prairie Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "CO",
            "postal_code": "806014006",
            "country_code": "US",
            "telephone_number": "970-405-5504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REFAAT",
        "first_name": "HEBAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "991639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO NP LICENSE",
            "identifier": "991639",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.