Individual provider Active NPI

Kevin F Rebeck, PA C

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1972551695
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110840540 Issued in VA
Practice address
397 Little Neck Rd Ste 120
Virginia Beach, VA 23452-5774
Phone
(757) 395-1600
Fax
(757) 961-9359
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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 0110840540 VA Primary

Addresses

Primary practice location

397 Little Neck Rd Ste 120
Virginia Beach, VA 23452-5774

Mailing address

397 Little Neck Rd Ste 120
Virginia Beach, VA 23452-5774
Phone (757) 395-1600

Other identifiers 5

IdentifierTypeStateIssuer
139178OtherVABCBS
P00387578OtherVARR MEDICARE
10014277POtherVASENTARA
1972551695MedicaidVA
10014277POtherVAOPTIMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070508000442 VA Practitioner - Physician Assistant 8820194897 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians
Mid-Atlantic Post Acute and Long Term Care PLLCGroup PAC ID 0648530782, 142 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 395-2323

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-4123

6160 Kempsville Cir
Suite 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110840540VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Jan 3, 2011 Accepting new patients

Locations

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

397 Little Neck Rd
Ste 120
Virginia Beach, VA 23452

397 Little Neck Rd
Ste 110
Virginia Beach, VA 23452
Phone (757) 395-1601

Interoperability endpoints

  • Direct secure messaging: krebeck18024@direct.sentara.net

Organizations & group practices 3

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 3

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1972551695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 LITTLE NECK RD STE 120",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234525774",
            "telephone_number": "757-395-1600",
            "fax_number": "757-961-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 LITTLE NECK RD STE 120",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234525774",
            "telephone_number": "757-395-1600",
            "fax_number": "757-961-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBECK",
        "first_name": "KEVIN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "139178",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00387578",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "10014277P",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972551695",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "10014277P",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.