Individual provider Active NPI

Matthew R. Rebesco, MD

  • Emergency Medicine Physician
  • Worcester, MA
National Provider Identifier
1962822528
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
270040 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 421-1400
Fax
(508) 421-1490
NPI assigned
Apr 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 270040 MA
Emergency Medicine Physician 207P00000X 270040 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other identifiers 1

IdentifierTypeStateIssuer
110118801AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170727001296 MA Practitioner - Emergency Medicine 0446476477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3020

133 Old Rd to Nine Acre Corner
Mary Beth Misserville
Concord, MA 01742-4159

38 Highland CMN E
Hudson, MA 01749-2047
Phone (978) 287-8990

830 Constitution Ave
Littleton, MA 01460-1137
Phone (978) 287-8990

Hospital & facility affiliations

  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
270040MAMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Practice Associates, Inc. CurrentSince May 30, 2023 Accepting new patients

Locations

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: mrebesco21653@umassmemorial.direct-ci.com
  • Direct secure messaging: rebesco.matthew.epa@direct.partners.masshiway.net

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1962822528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBESCO",
        "first_name": "MATTHEW",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-22",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MA",
            "license": "270040",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "270040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110118801A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.