Individual provider Active NPI

Sharon Levina Revan, M.D.

  • Rheumatology Physician
  • White Plains, NY
National Provider Identifier
1306956248
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
191108 Issued in NY
Practice address
3 Barker Ave
4TH Floor
White Plains, NY 10601-1509
Phone
(914) 949-1199
Fax
(914) 949-1245
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 191108 NY Primary

Addresses

Primary practice location

3 Barker Ave
4TH Floor
White Plains, NY 10601-1509

Mailing address

502 Park Ridge LN
White Plains, NY 10603-3122
Phone (914) 649-9952

Other identifiers 1

IdentifierTypeStateIssuer
01666962MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025001362 NY Practitioner - Internal MedicinePractitioner - Rheumatology 1759574544 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Home Lifecare, Manhattan CurrentSince Aug 31, 2016 Accepting new patients
Jewish Home Lifecare, Manhattan CurrentSince Aug 31, 2016 Accepting new patients
Hospitalist Healthcare Services PLLC Past Accepting new patients

Locations

120 W 106th St
New York, NY 10025
Phone (212) 870-4715

120 W 106th St
Fl 4
New York, NY 10025

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1306956248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 PARK RIDGE LN",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106033122",
            "telephone_number": "914-649-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BARKER AVE",
            "address_2": "4TH FLOOR",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011509",
            "telephone_number": "914-949-1199",
            "fax_number": "914-949-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVAN",
        "first_name": "SHARON",
        "middle_name": "LEVINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "191108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01666962",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.