Jorge Manuel Revelo Escobar, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

316622-01 Issued in NY

Practice address

7901 Broadway
Elmhurst, NY 11373-1329

Phone

(718) 334-2156

NPI assigned

Jul 24, 2018

Sex

Male

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 NY

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jreveloescobar360113@nychhc.direct-ci.com

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1679050579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELO ESCOBAR",
        "first_name": "JORGE",
        "middle_name": "MANUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "316622-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge J Restrepo, R.PH.
• Pablo A Restrepo, PHARM.D
• Retina & Ophthalmology Services of New York PLLC
• Candace Alexis Reuben
• Juan Carlos Revelli, NURSE PRACTITIONER
• Julianne Francesca Flores Reyes
• Julio Reyes, NP
• Paolo Angelo Santos Reyes, BSN, RN
• Trinidad Reyes
• Deborah Anita Reynolds, MD

• Pediatrics Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.