David M Revak, D. O.

Individual provider Active NPI Family Medicine Physician · Reinholds, PA

NPI 1013029503 · NPPES record last updated Jun 14, 2011

Key facts

NPI
1013029503
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
OS005938L (PA)
Practice address
171 Chapel View Dr
Reinholds, PA 17569-0119
Phone
(717) 336-5824
Fax
(717) 336-5401
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS005938LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Monaca Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Ephrata Community Hospital Past Accepting new patients
Chiropractic Head&Neck Treatment Center Past
since Jul 9, 2014
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS005938L PA Yes

Addresses

Primary practice location

171 Chapel View Dr
Reinholds, PA 17569-0119

Mailing address

171 Chapel View Dr
P. O. Box 119
Reinholds, PA 17569-0119
Phone (717) 336-5824

Other identifiers

IdentifierTypeStateIssuer
542115OtherBLUE SHIELD
50051246OtherCAPITAL BLUE
P005066OtherGATEWAY
4641800OtherAETNA
P00262037OtherRAILROAD MEDICARE
0011813120004MedicaidPA
5838474OtherUSH/HMO

Other providers in Reinholds, PA

All providers in Reinholds, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.