Revision Health Services, Pllc is a medicare enrolled "Clinic/center - Physical Therapy" provider in Ponte Vedra, Florida. Their current practice location is
131 Valley Grove Dr, Ponte Vedra, Florida. You can reach out to their office (for appointments etc.) via phone at
(309) 267-9873.
Revision Health Services, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Revision Health Services, Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1659994911.
Healthcare Provider's Profile
| Full Name | Revision Health Services, Pllc |
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| Type | Facility |
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| Speciality | Clinic/center - Physical Therapy |
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| Location | 131 Valley Grove Dr, Ponte Vedra, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1659994911
- Provider Enumeration Date: 05/21/2020
- Last Update Date: 05/29/2020
Medicare PECOS Information:
- PECOS PAC ID: 4981026523
- Enrollment ID: O20200626001841
Medical Identifiers
Medical identifiers for Revision Health Services, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659994911 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Revision Health Services, Pllc acts as a billing entity for following providers:
| Provider Name | Michael Derry |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1285015024
PECOS PAC ID: 2163738790
Enrollment ID: I20200630000462 |
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| Provider Name | Christopher Pregony |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1639945447
PECOS PAC ID: 4789034562
Enrollment ID: I20231219003477 |
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| Provider Name | Hannah Rawlings |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1508330200
PECOS PAC ID: 3274905666
Enrollment ID: I20240523001632 |
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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. Revision Health Services, Pllc 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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Revision Health Services, Pllc
908 W 1st St,
Spring Valley, IL 61362-1135
Ph: (309) 267-9873 | Revision Health Services, Pllc
131 Valley Grove Dr,
Ponte Vedra, FL 32081-6165
Ph: (309) 267-9873 |
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