NPIMap

Organization Active NPI

Revive PCMS Highland Park PLLC

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1124909353
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
REVIVE PCMS HIGHLAND PARK PLLC
Practice address
3330 Douglas Ave
Dallas, TX 75219-2717
Phone
(972) 236-7060
NPI assigned
Sep 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ali Alheleji
Title
Ceo/Owner
Phone
(972) 236-7060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3330 Douglas Ave
Dallas, TX 75219-2717

Mailing address

3330 Douglas Ave
Dallas, TX 75219-2717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251114001453 TX Part B Supplier - Clinic/Group Practice 3072004373 Receives reassigned benefits from 6 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1124909353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 DOUGLAS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 DOUGLAS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192717",
            "telephone_number": "972-236-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PCMS HIGHLAND PARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "ALHELEJI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "972-236-7060"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.