REHABILITATION HOSPITAL, LLC
NPI 1174021695
Rehabilitation Hospital in Tyler, TX
About Rehabilitation Hospital, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REHABILITATION HOSPITAL, LLC (NPI 1174021695) is a healthcare organization registered as a rehabilitation hospital in Tyler, Texas and active in the NPI registry since January 2018. The organization holds a CLIA Waiver certificate valid through June 25, 2027 and lists Stephen C Petrovich, Evp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rehabilitation Hospital, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Rehabilitation Hospital, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D0902643
Rehabilitation Hospital, LLC · Tyler, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Rehabilitation Hospital, LLC's NPI number?
The NPI number for Rehabilitation Hospital, LLC is 1174021695. It was assigned to this organization in the NPPES registry on January 30, 2018.
Where is Rehabilitation Hospital, LLC located?
Rehabilitation Hospital, LLC is located at 701 Olympic Plaza Cir, Tyler, TX 75701. The listed phone number is (903) 596-3000.
What is Rehabilitation Hospital, LLC's specialty?
The primary specialty registered for this NPI is Rehabilitation Hospital with taxonomy code 283X00000X.
Is Rehabilitation Hospital, LLC enrolled in Medicare?
Yes. Rehabilitation Hospital, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Rehabilitation Hospital, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Anesthesiology) reassigns their Medicare billing to Rehabilitation Hospital, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Rehabilitation Hospital, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D0902643) is associated with this NPI, valid through June 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Rehabilitation Hospital, LLC accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Rehabilitation Hospital, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Rehabilitation Hospital, LLC was last updated on October 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Rehabilitation Hospital, Llc · NPI 1174021695
Rehabilitation Hospital organization in Tyler, Texas. Organization record, active in the CMS NPPES registry since January 30, 2018.
## Identity
- **NPI:** 1174021695 (Entity type: Organization)
- **Enumerated:** January 30, 2018
- **Primary specialty:** Rehabilitation Hospital · taxonomy 283X00000X
- **Organization subpart:** Yes (part of Ahs East Texas Health System Llc)
- **Authorized official:** Stephen Petrovich, EVP
## Practice location
- **Address:** 701 OLYMPIC PLAZA CIR, Tyler, TX 75701-1950
- **Phone:** (903) 596-3000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Anesthesiology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 1, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174021695) · Data from the CMS NPPES public registry.