Gina Revzin, P.A,

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

009155 Issued in NY

Practice address

627 Broadway Ste 1
Massapequa, NY 11758-5031

Phone

(516) 541-4171

Fax

(516) 377-5712

NPI assigned

Jan 13, 2010

Sex

Female

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

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brain and Spine Surgeons of New York PCGroup PAC ID 7113818139, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Brain & Spine Surgeons of New York PC

  • Surgery Physician
  • White Plains, NY
  • NPI 1992921407
  Medicare reassignment Care Compare group
• Ear, Nose & Throat Associates of New York,P.C.

  • Facial Plastic Surgery Physician
  • Fresh Meadows, NY
  • NPI 1124079769
  NPD

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1346570322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915139",
            "telephone_number": "914-333-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 BROADWAY STE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-541-4171",
            "fax_number": "516-377-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVZIN",
        "first_name": "GINA",
        "name_prefix": "Mrs.",
        "credential": "P.A,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Antoinette Reip
• Allen Reji
• Reliance Healthcare LLC
• Relief Source Chiropractic PC
• Amalia Rentas-Schoop, LMT
• Toussaint Andre Reynolds, M.D.
• Paul Ricca, D.O.
• Ricco Dental Group
• Richard J. Bebirian, DO PC
• Donna Riggio, OTR/L

• Medical Physician Assistant in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.