Ronelle Revilla

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61065135 Issued in WA

Practice address

1100 9TH Ave
Seattle, WA 98101-2756

Phone

(206) 341-0394

NPI assigned

Mar 4, 2020

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

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment Care Compare group NPD
• Virginia Mason Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD
• Virginia Mason Medical Center

  • Nephrology Physician
  • Seattle, WA
  • NPI 1962568261
  NPD

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

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Care Compare affiliation

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1528693181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-341-0394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific Street",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98195",
            "country_code": "US",
            "telephone_number": "206-543-8736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVILLA",
        "first_name": "RONELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60560871",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61065135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geanna N Revell, RDN, CD
• Marci Revelli, MS CCC/SLP
• Roma Moriah Revels, RN
• Reverve LLC
• Daniel Revette, LMT
• Gabija Revis, DMD
• Revive Behavioral Health
• Revive Health Concierge
• Revive Low T, LLC
• Revive Movement LLC

• Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.