Gene Casamera Reavis III, CO

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CO264177 Issued in PA

Practice address

901 S 55TH St Unit A2
Phila, PA 19143-4005

Phone

(215) 474-4767

NPI assigned

Sep 28, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• G Casamera Hair Salon & Day Spa, LLC.

  • Prosthetic/Orthotic Supplier
  • Philadelphia, PA
  • NPI 1154101319
  NPD Authorized official

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1659150696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S 55TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191434005",
            "telephone_number": "215-474-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S 55TH ST UNIT A2",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191434005",
            "telephone_number": "215-474-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVIS",
        "first_name": "GENE",
        "middle_name": "CASAMERA",
        "name_suffix": "III",
        "credential": "CO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "PA",
            "license": "CO264177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramcel Munoz Quien, MD
• Harris Rabinovich, MD
• Howard K Rabinowitz, M.D.
• Julia Rainer, MSS, LSW, LMSW
• Neil Stuart Rapoport, DPM
• Renzi Medical,PC
• Danis Lee Reynolds
• Leon Jay Reznik, D.P.M.
• Ernest J Ricco, MD
• Richard Skaroff, M.D.

• Prosthetic/Orthotic Supplier in Phila, PA
• Providers in Phila, PA by specialty
• Prosthetic/Orthotic Supplier in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.