Sergey Revega, CRNA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

2090121874 Issued in IL

Practice address

611 W. Park St.
Anesthesiology
Urbana, IL 61801-2500

Phone

(217) 383-3303

Fax

(217) 383-3265

NPI assigned

Jul 21, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, IL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  Medicare reassignment NPD
• Anesthesia & Pain Consultants of SW FL

  • Specialist
  • Fort Myers, FL
  • NPI 1609843275
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Medical-Surgical Registered Nurse
  • Hoopeston, IL
  • NPI 1457422164
  NPD
• Outpatient Anesthesia of Southwest Florida Inc

  • Specialist
  • Fort Myers, FL
  • NPI 1518244383
  NPD (past)

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

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• The Carle Foundation Hospital

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1013071653
  Care Compare affiliation

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1487061636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "ANESTHESIOLOGY",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-3303",
            "fax_number": "217-383-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVEGA",
        "first_name": "SERGEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9296749",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IL",
            "license": "2090121874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heather Leigh Restivo
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• Yana V. Reynolds, CRNA
• Benjamin J Rhee, MD
• Joyce S Rhee, MD

• Anesthesiologist Assistant in Urbana, IL
• Providers in Urbana, IL by specialty
• Anesthesiologist Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.