Individual provider Active NPI

Rebecca M Brewer, PA-C

  • Physician Assistant
  • La Pine, OR
National Provider Identifier
1972656700
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01033 Issued in OR
Practice address
51600 Huntington Rd
La Pine, OR 97739-8887
Phone
(541) 536-3435
Fax
(541) 536-8047
NPI assigned
Jan 18, 2007
Last updated
Mar 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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 PA01033 OR Primary

Addresses

Primary practice location

51600 Huntington Rd
La Pine, OR 97739-8887

Mailing address

PO Box 3300
La Pine, OR 97739-3300
Phone (541) 536-3435

Other names 1

  • Rebecca M Short Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20170313001217 OR Practitioner - Physician Assistant 7719261791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Pine Community Health CenterGroup PAC ID 8224187018, 13 clinicians

Practice addresses (Care Compare)

51600 Huntington Rd
La Pine, OR 97739-9626

51600 S Huntington Dr
Suite C
Lapine, OR 97739-9626
Phone (541) 536-3435

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01033ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
La Pine Community Health Center CurrentSince Mar 1, 2017 Accepting new patients
La Pine Community Health Center Past Accepting new patients

Locations

51600 Huntington Rd
La Pine, OR 97739
Phone (541) 385-7129

51600 Huntington Rd
Ste 101
La Pine, OR 97739
Phone (541) 536-3435

51600 Huntington Rd
Ste C
La Pine, OR 97739
Phone (541) 536-3435

Interoperability endpoints

  • Direct secure messaging: rbrewer198644@direct.ochin.org

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.

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1972656700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3300",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977393300",
            "telephone_number": "541-536-3435",
            "fax_number": "541-536-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51600 HUNTINGTON RD",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977398887",
            "telephone_number": "541-536-3435",
            "fax_number": "541-536-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "REBECCA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "SHORT",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Pine, OR

Sources for this page

Verify at the official NPI Registry.