Rebecca Grace Ilgen, PAC
Individual provider Active NPI Physician Assistant · Crisfield, MD
NPI 1801852017 · NPPES record last updated Apr 29, 2014
Key facts
- NPI
- 1801852017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- C0000562 (MD)
- Practice address
- 201 Hall Highway
Crisfield, MD 21817 - Phone
- (410) 968-1200
- Fax
- (410) 968-3005
- NPI assigned
- Apr 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190910001333 | MD | Practitioner - Physician Assistant | 1254551567 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McCready Foundation Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0000562 | MD | Yes |
Addresses
Primary practice location
201 Hall Highway
Crisfield, MD 21817
Mailing address
201 Hall Highway
Crisfield, MD 21817
Phone (410) 968-1200
Other providers in Crisfield, MD
- Focus Point Solutions LLC
- Robey Ann French
- Frank E Goldman
- Lori H Goldsborough
- Howard Mark Haft
- Inspiration Health Services, LLC
- Skyler Brooke Irons
- Stephanie James
- Vijaykumar Karumbunathan
- Kevin Christopher Kearney
All providers in Crisfield, MD · Physician Assistant in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.