Individual provider Active NPI

Mary Stunja Revers, PA-C

  • Medical Physician Assistant
  • Greensburg, PA
National Provider Identifier
1396191771
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
IN PROCESS Issued in WV
Practice address
532 W Pittsburgh St
Greensburg, PA 15601-2239
Phone
(724) 832-4358
NPI assigned
May 4, 2016
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X IN PROCESS WV Primary

Addresses

Primary practice location

532 W Pittsburgh St
Greensburg, PA 15601-2239

Mailing address

1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200

Other practice location 1

1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrevers@direct.excelahealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160907001621 WV Practitioner - Physician Assistant 9739475484 Reassigns benefits to 2 organizations
I20170105001005 PA Practitioner - Physician Assistant 9739475484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.39 of 100Reported as group
Quality
79.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
IN PROCESSWVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monongalia County General Hospital Company CurrentSince Feb 1, 2024 Accepting new patients

Locations

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

Interoperability endpoints

  • Direct secure messaging: mrevers@direct.excelahealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1396191771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 J D ANDERSON DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053494",
            "telephone_number": "304-598-1200",
            "fax_number": "304-598-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 W PITTSBURGH ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012239",
            "telephone_number": "724-832-4358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 J D Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265053494",
            "country_code": "US",
            "telephone_number": "304-598-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVERS",
        "first_name": "MARY",
        "middle_name": "STUNJA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "IN PROCESS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrevers@direct.excelahealth.org",
            "affiliation": "N",
            "endpointDescription": "Excela Health Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "532 W Pittsburgh St",
            "city": "Greensburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156012239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.