Annette O Revak, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

V1870 Issued in TX

Practice address

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Phone

(972) 715-5000

Fax

(972) 715-9976

NPI assigned

Oct 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Annette Ortegon Former name

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

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 2

Specialty

Anesthesiology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Afterglow Anesthesia PLLCGroup PAC ID 8022543370, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Central Surgical Center LLP Hospital, Dallas, TX, CCN 670049
• Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
• Legent Orthopedic Hospital Hospital, Grapevine, TX, CCN 670265
• Baylor Medical Center at Trophy Club Hospital, Trophy Club, TX, CCN 450883
• Texas Health Harris Methodist Hospital Southlake Hospital, Southlake, TX, CCN 450888

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 28)

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.

• Afterglow Anesthesia PLLC

  • Anesthesiology Physician
  • Mesquite, TX
  • NPI 1558180083
  Medicare reassignment Care Compare group NPD
• Texas Anesthesia Partners, PLLC

  • Anesthesiology Physician
  • Southlake, TX
  • NPI 1144673468
  Medicare reassignment NPD
• U. S. Anesthesia Partners of Texas, P.a.,

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1548208564
  Medicare reassignment NPD
• Southern Arizona Anesthesia Services, PC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1912999343
  Medicare reassignment NPD
• Yuma Regional Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Medicare reassignment NPD
• U S Anesthesia Partners of Texas, PA

  • Interventional Pain Medicine Physician
  • Addison, TX
  • NPI 1053800391

  Anesthesiology

  NPD
• Yuma Regional Medical Center

  • General Practice Physician
  • Yuma, AZ
  • NPI 1598993420
  NPD

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

• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1023180502
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  Care Compare affiliation
• Ethicus Hospital DFW LLC

  • General Acute Care Hospital
  • Carrollton, TX
  • NPI 1316505043
  Care Compare affiliation
• Ethicus Hospital DFW LLC

  • Long Term Care Hospital
  • Grapevine, TX
  • NPI 1659536944
  Care Compare affiliation
• Ethicus Hospital DFW, LLC

  • Rehabilitation Hospital Unit
  • Carrollton, TX
  • NPI 1356133615
  Care Compare affiliation
• North Central Surgical Center L.L.P.

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1548236524
  Care Compare affiliation
• Southlake Specialty Hospital, LLC

  • General Acute Care Hospital
  • Southlake, TX
  • NPI 1629064928
  Care Compare affiliation
• Trophy Club Medical Center LP

  • General Acute Care Hospital
  • Trophy Club, TX
  • NPI 1982609558
  Care Compare affiliation

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1356339808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3390 N Campbell Ave",
            "address_2": "STE 110",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857192380",
            "country_code": "US",
            "telephone_number": "520-795-7650",
            "fax_number": "520-325-1622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 S Avenue A",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853647170",
            "country_code": "US",
            "telephone_number": "928-344-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVAK",
        "first_name": "ANNETTE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "V1870",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "34261",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "ORTEGON",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark David Reusche, MD
• Taylor Reusche
• Ashleigh Reuter
• Emma Reutimann, PHD
• Reva Diagnostics LLC
• Revelation Counseling and Consulting, Inc
• Jeanne Buenaflor Reveldez, FNP
• Guadalupe Reveles
• Melissa Reveles, OD
• Sonia Reveles, CRNA

• Anesthesiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.