Ricardo Arsenio Revilla, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME106166 Issued in FL

Practice address

145 Country Club Dr W
Destin, FL 32541-4437

Phone

(305) 333-8436

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
• HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ricardo.revilla@cfwah-fl.direct.office.nextgen.com

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.

• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• Floridian Emergency Specialists LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1710210695
  Medicare reassignment NPD
• Hospital Medicine Services of FL, LLC

  • Hospitalist Physician
  • Aventura, FL
  • NPI 1710684857
  Medicare reassignment NPD
• Rojas Medical Center, LLC

  • Family Medicine Physician
  • Miami, FL
  • NPI 1790434231
  Medicare reassignment NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  FL

  Medicare reassignment NPD
• Chicot Memorial Hospital

  • Critical Access Hospital
  • Lake Village, AR
  • NPI 1497701973
  NPD (past)
• De Queen Medical Center Inc

  • Critical Access Hospital
  • De Queen, AR
  • NPI 1154423523
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Walton Beach Medical Center, Inc.

  • General Acute Care Hospital
  • Ft Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation
• Putnam Community Medical Center of North Florida, LLC

  • General Acute Care Hospital
  • Palatka, FL
  • NPI 1487045100
  Care Compare affiliation

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1326255142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 COUNTRY CLUB DR W",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414437",
            "telephone_number": "305-333-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 COUNTRY CLUB DR W",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414437",
            "telephone_number": "305-333-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVILLA",
        "first_name": "RICARDO",
        "middle_name": "ARSENIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME106166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "5N986",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regatta Chiropractic Laser and Wellness Center Inc
• Ciara Nicole Reistad, MS, RDN, LDN
• Rementis Health Group LLC
• Richard Charles Reno, M.D.
• Restoration Transformation
• Richard J. Rogers, DMD, PA
• Rifa Royal Lengths LLC
• Caroline Elizabeth Riffe, APRN
• Carla Riley, PTA
• Meghan Eve Rivera, BCBA

• Emergency Medicine Physician in Destin, FL
• Providers in Destin, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.