Individual provider Active NPI

Rebekah Dale Bard-Carvalho, FNP

  • Nurse Practitioner
  • Saint Francis, WI
National Provider Identifier
1821851213
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14890 Issued in WI
Practice address
3272 E Thompson Ave
Saint Francis, WI 53235-4916
Phone
(269) 861-0688
NPI assigned
Jan 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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 14890 WI Primary

Addresses

Primary practice location

3272 E Thompson Ave
Saint Francis, WI 53235-4916

Mailing address

3272 E Thompson Ave
Saint Francis, WI 53235-4916
Phone (269) 861-0688

Other identifiers 1

IdentifierTypeStateIssuer
100279544MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rbardcarvalho401020@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240805002256 WI Practitioner - Nurse Practitioner 9931646247 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

14555 W National Ave
Suite 120
New Berlin, WI 53151-4494
Phone (262) 827-2955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14890WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jun 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

14555 W National Ave
Ste 120
New Berlin, WI 53151
Phone (262) 827-2955

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

3289 N Mayfair Rd
Wauwatosa, WI 53222
Phone (414) 771-7900

Interoperability endpoints

  • Direct secure messaging: rbardcarvalho401020@direct.myadvocateaurora.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1821851213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3272 E THOMPSON AVE",
            "city": "SAINT FRANCIS",
            "state": "WI",
            "postal_code": "532354916",
            "telephone_number": "269-861-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3272 E THOMPSON AVE",
            "city": "SAINT FRANCIS",
            "state": "WI",
            "postal_code": "532354916",
            "telephone_number": "269-861-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARD-CARVALHO",
        "first_name": "REBEKAH",
        "middle_name": "DALE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "14890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100279544",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbardcarvalho401020@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3289 N Mayfair Rd",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532223203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3289 N Mayfair Rd",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532223203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Francis, WI

Sources for this page

Verify at the official NPI Registry.