NPIMap

Individual provider Active NPI

Rebecca Lynn Bennett, PA-C

  • Physician Assistant
  • Staples, MN
National Provider Identifier
1831189117
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9463 Issued in MN
Practice address
49725 County 83
Staples, MN 56479-5280
Phone
(218) 894-1515
Fax
(218) 894-8767
NPI assigned
Oct 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 9463 MN Primary

Addresses

Primary practice location

49725 County 83
Staples, MN 56479-5280

Mailing address

49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040116000125 MN Practitioner - Physician Assistant 0345141099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Health System 107 clinicians

Practice addresses (Care Compare)

49725 County
Suite 83
Staples, MN 56479-5280
Phone (218) 894-1515

Hospital & facility affiliations

  • Vivie Home Health Home health agency, Alexandria, MN, CCN 248096
  • Lakewood Health System Hospital, Staples, MN, CCN 241329

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9463MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Health System CurrentSince Mar 11, 2000 Accepting new patients
Lakewood Health System CurrentSince Mar 11, 2000 Accepting new patients
Lakewood Health System CurrentSince Jan 7, 2026 Accepting new patients

Locations

333 Gillis Ave S
Browerville, MN 56438
Phone (320) 594-2231

1233 Highway 10 S
Motley, MN 56466
Phone (218) 352-6337

653 Pillsbury St N
Ste 1
Pillager, MN 56473
Phone (218) 746-4550

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

Interoperability endpoints

  • Direct secure messaging: rbennett625953@direct.ochin.org

Organizations & group practices 16

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.

View all 16

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1831189117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staples, MN

Sources for this page

Verify at the official NPI Registry.