REBECCA F NISHIMOTO (PA-C) – Surgical Physician Assistant, NPI 1073624664
Surgical Physician Assistant
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for REBECCA F NISHIMOTO (PA-C)
7200, North Ridge Boulevard, West Ridge, Chicago, Rogers Park Township, Cook County, Illinois, 60645, United States
UNIT 4H
CHICAGO, IL 606452056
Phone: (773) 499-8180
Type: Mailing
Highland Park Hospital, 777, Park Avenue West, Highland Park, Lake County, Illinois, 60035, United States
HIGHLAND PARK, IL 600352433
Phone: (847) 926-5844
Type: Location
2650 RIDGE AVE STE 1223
EVANSTON, IL 602011700
Phone: (847) 982-6710
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040119000249 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60645)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| N E U R O L O G Y | IL | |
| Hospitalist, Internal Medicine | IL | |
| O P H T H A L M O L O G Y | IL | |
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | IL | |
| Clinical Social Worker | IL | |
| Certified Nurse Midwife (Cnm) | IL |
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