Revital Ahl

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

58759 Issued in CA

Practice address

18141 Medley Dr
Encino, CA 91316-4447

Phone

(818) 422-4077

NPI assigned

Oct 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Oxygenwell Hyperbaric and Regenerative Medicine Corp

  • Health Service Clinic/Center
  • Calabasas, CA
  • NPI 1801760996
  Medicare reassignment NPD
• La Hyperbaric Oxygen Center LLC

  • Clinic/Center
  • Tarzana, CA
  • NPI 1023716552
  Medicare reassignment

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1538769062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18141 MEDLEY DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18141 MEDLEY DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164447",
            "telephone_number": "818-422-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHL",
        "first_name": "REVITAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lisbeth Aguilar
• Victoria Aguilar, BCBA
• Kassandra Aguirre
• Samantha Marie Aguirre
• Elinor Ahl
• Venous Ahmadipour
• Aim Home Care Inc West la
• Dennis Ainbinder, M.D.
• David Harlan Aizuss, M.D.
• Aj Physical Therapy Inc

• Physician Assistant in Encino, CA
• Providers in Encino, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.