Juan Carlos Revelli, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403827 Issued in NY

Practice address

7901 Broadway
Elmhurst, NY 11373-1329

Phone

(718) 334-3507

Fax

(718) 334-5006

NPI assigned

Jun 5, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elmhurst Hospital Center Hospital, Elmhurst, NY, CCN 330128

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jrevelli681573@nychhc.direct-ci.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.

• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment Care Compare group NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • Jackson Heights, NY
  • NPI 1225765621
  NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD

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

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Elmhurst, NY
  • NPI 1063426377
  Care Compare affiliation

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1336833144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3507",
            "fax_number": "718-334-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3507",
            "fax_number": "718-334-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELLI",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Restrepo
• Jorge J Restrepo, R.PH.
• Pablo A Restrepo, PHARM.D
• Retina & Ophthalmology Services of New York PLLC
• Candace Alexis Reuben
• Jorge Manuel Revelo Escobar, MD
• Julianne Francesca Flores Reyes
• Julio Reyes, NP
• Paolo Angelo Santos Reyes, BSN, RN
• Trinidad Reyes

• Psychiatric/Mental Health Nurse Practitioner in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.