NPIMap

Organization Active NPI

Revascmedprofessionals PC

Doing business as ReVamp

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1669074795
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
REVASCMEDPROFESSIONALS PC
Doing business as
ReVamp
Practice address
2418 E York St
Philadelphia, PA 19125-3006
Phone
(267) 887-0013
Fax
(833) 972-5088
NPI assigned
Nov 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Authorized official

Name
Jon C George, MDNPI 1992746721
Title
Owner
Phone
(215) 575-5906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

2418 E York St
Philadelphia, PA 19125-3006

Mailing address

2418 E York St
Philadelphia, PA 19125-3006
Phone (267) 887-0013

Other practice location 1

510 N Broad St Ste 202
Philadelphia, PA 19130-4335
Phone (267) 548-4216

Other practice location 2

170 N Henderson Rd Ste 310
King Of Prussia, PA 19406-2155
Phone (267) 548-4172

Other practice location 3

727 Welsh Rd Ste 103B
Huntingdon Valley, PA 19006-6357
Phone (267) 951-3328

Other names 1

  • ReVamp Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201118001618 PA Part B Supplier - Clinic/Group Practice 6800207168 Receives reassigned benefits from 7 practitioners
Practice locations: King of Prussia, PA; Huntingdon Valley, PA; Philadelphia, PA; Langhorne, PA

National Provider Directory

National Provider Directory

Locations

727 Welsh Rd
Ste 103B
Huntingdon Valley, PA 19006
Phone (267) 951-3328

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750982400000",
    "number": "1669074795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 E YORK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253006",
            "telephone_number": "267-887-0013",
            "fax_number": "833-972-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 E YORK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253006",
            "telephone_number": "267-887-0013",
            "fax_number": "833-972-5088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 N Broad St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191304335",
            "country_code": "US",
            "telephone_number": "267-548-4216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 N Henderson Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194062155",
            "country_code": "US",
            "telephone_number": "267-548-4172",
            "fax_number": "833-972-5534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 Welsh Rd Ste 103B",
            "address_purpose": "LOCATION",
            "city": "Huntingdon Valley",
            "state": "PA",
            "postal_code": "190066357",
            "country_code": "US",
            "telephone_number": "267-951-3328",
            "fax_number": "833-972-5534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVASCMEDPROFESSIONALS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-575-5906",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ReVamp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.