Individual provider Active NPI

Rebecca Anne Triebold, PA-C

  • Medical Physician Assistant
  • Chula Vista, CA
National Provider Identifier
1881392926
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA62275 Issued in CA
Practice address
333 H St Ste 2000
Chula Vista, CA 91910-5556
Phone
(619) 427-0665
NPI assigned
Feb 17, 2023
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA62275 CA
Medical Physician Assistant 363AM0700X PA62275 CA Primary

Addresses

Primary practice location

333 H St Ste 2000
Chula Vista, CA 91910-5556

Mailing address

333 H St Ste 2000
Chula Vista, CA 91910-5556
Phone (619) 427-0665

Other names 1

  • Ms. Rebecca Anne Piechur Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230407000240 CA Practitioner - Physician Assistant 3870968712 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62275CAMDPeriodontist
PA62275CAMDFamily Medicine Physician

Organizations & group practices 2

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": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1881392926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 H ST STE 2000",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105556",
            "telephone_number": "619-427-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 H ST STE 2000",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105556",
            "telephone_number": "619-427-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIEBOLD",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA62275",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA62275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "PIECHUR",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.