Individual provider Active NPI

Revital Metro

  • Physician Assistant
  • Morgantown, WV
National Provider Identifier
1427593425
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1075 Van Voorhis Rd Ste 150
Morgantown, WV 26505
Phone
(304) 598-6216
NPI assigned
Dec 29, 2016
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

1075 Van Voorhis Rd Ste 150
Morgantown, WV 26505

Mailing address

PO Box 780
Morgantown, WV 26507-0780
Phone (304) 285-7101

Other practice location 1

1203 Pittsburgh Road
Suite 101
Uniontown, PA 15401
Phone (724) 912-6800 ext. 27045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20241115002173 WV Practitioner - Physician Assistant 2264966035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
West Virginia University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

1075 Van Voorhis Rd
FL 2
Morgantown, WV 26505-3586
Phone (304) 598-6216

1075 Van Voorhis Rd
Suite 150
Morgantown, WV 26505-3588
Phone (304) 598-6216

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Aug 1, 2024 Accepting new patients
Wvu Med Corp Cheat Lake Physicians CurrentSince Aug 1, 2024 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1075 Van Voorhis Rd
Ste 150
Morgantown, WV 26505
Phone (304) 598-0122

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1427593425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-285-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 VAN VOORHIS RD STE 150",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "304-598-6216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Pittsburgh Road",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "PA",
            "postal_code": "15401",
            "country_code": "US",
            "telephone_number": "724-912-6800 x27045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METRO",
        "first_name": "REVITAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.