Vidyashankar B Revan, MD is a medicare enrolled "Allergy & Immunology" physician in Wilmington, Ohio. He graduated from medical school in 1987 and has 37 years of diverse experience with area of expertise as Allergy/immunology. He is a member of the group practice Psf Pllc and his current practice location is
110 Fairway Dr, Suite # 2, Wilmington, Ohio. You can reach out to his office (for appointments etc.) via phone at
(937) 655-9179.
Vidyashankar B Revan is licensed to practice in Ohio (license number 35080833) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1194882571.
Physician's Profile
| Full Name | Vidyashankar B Revan |
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| Gender | Male |
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| Speciality | Allergy/immunology |
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| Experience | 37 Years |
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| Location | 110 Fairway Dr, Wilmington, Ohio |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Vidyashankar B Revan graduated from medical school in 1987
NPI Data:
- NPI Number: 1194882571
- Provider Enumeration Date: 01/03/2007
- Last Update Date: 05/26/2021
Medicare PECOS Information:
- PECOS PAC ID: 9032147400
- Enrollment ID: I20111031000181
Medical Identifiers
Medical identifiers for Vidyashankar B Revan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1194882571 | NPI | - | NPPES |
| 2321660 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207K00000X | Allergy & Immunology | 35080833 (Ohio) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Psf Pllc | 1557265543 | 97 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Vidyashankar B Revan allows following entities to bill medicare on his behalf.
| Entity Name | Psf Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881785947
PECOS PAC ID: 1557265543
Enrollment ID: O20180910001695 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Vidyashankar B Revan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Vidyashankar B Revan, MD
9800 Shelbyville Rd Ste 220,
Louisville, KY 40223-2992
Ph: (502) 429-8585 | Vidyashankar B Revan, MD
110 Fairway Dr, Suite # 2,
Wilmington, OH 45177-8756
Ph: (937) 655-9179 |
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