Rebecca Barrick

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085002089 Issued in IL

Practice address

5401 N Knoxville Ave Ste 115
Peoria, IL 61614-5068

Phone

(309) 691-2903

Fax

(309) 691-2909

NPI assigned

Nov 22, 2006

Last updated

Oct 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecca Studebaker Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Central Illinois Dermatology SCGroup PAC ID 2860463510, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Central Illinois Dermatology, S.C.

  • Dermatology Physician
  • Peoria, IL
  • NPI 1548358054
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1952476103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE STE 115",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145095",
            "telephone_number": "309-691-2903",
            "fax_number": "309-691-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE STE 115",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145068",
            "telephone_number": "309-691-2903",
            "fax_number": "309-691-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRICK",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085002089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "STUDEBAKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barbara Barnewolt
• Emily L Barnewolt, FNP
• Kyle Thomas Barnhart, MD
• Savannah Barnwell
• Victoria Barragan, LPC
• Jasira Barrientos
• Chloe Nicole Bartelmay, CNA
• Andrea Bartlett, MSW
• Kenneth A. Bartman Jr., CRNA
• Marco Barzallo, M.D.

• Surgical Physician Assistant in Peoria, IL
• Providers in Peoria, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.