Bassem Rezk

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

297011171 Issued in IL

Practice address

3515 W Union Hills Dr Ste 111
Glendale, AZ 85308-2430

Phone

(929) 308-5775

NPI assigned

Aug 17, 2022

Last updated

Aug 17, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1487372314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22010 N 73RD LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105297",
            "telephone_number": "929-308-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 W UNION HILLS DR STE 111",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853082430",
            "telephone_number": "929-308-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZK",
        "first_name": "BASSEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "TPPA961",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2022027022",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R79181",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "297011171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Wellness and Rejuvenation LLC
• Jacob Reyes
• Lisa T. Reyes, O.D.
• Virginia Rivas Reyes
• Elizabeth Michele Reyna
• RGL Development, LLC
• Rhino's Med. Trans, LLC
• Torre Rhoades, MD
• Elizabeth Ariana Ricca, CRNFA
• Charan Norwakis Rice, PHARM. D

• Internal Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.