Active NPI
Jonathan W Revels, DO
- Diagnostic Radiology Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- OP60730003
- Practice address
- 2211 Lomas Blvd NE
Albuquerque, NM 87106-2719 - Phone
- (505) 272-1476
- NPI assigned
- May 17, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | A-2207-19 | NM | |
| Diagnostic Radiology Physician | 2085R0202X | OP60730003 | WA | Primary |
Addresses
Primary practice location
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Mailing address
PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700
Other practice location 1
1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-7200
Other practice location 2
1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750674164 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, NY, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Touro Un College of Osteopathic Medicine, Vallejo, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
1300 Ave P
Brooklyn, NY 11229-1106
Phone (718) 376-1004
13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923
1530 Front St
East Meadow, NY 11554-2265
Phone (516) 324-7500
159 E 53Rd St
New York, NY 10022-4602
Phone (646) 754-3300
160 E 34TH St
New York, NY 10016-4744
Phone (212) 263-7300
16244 S Military TRL
560 NYU Langone Cardiology Delray Bea
Delray Beach, FL 33484-6532
Phone (561) 495-7787
180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900
2318 31St St
Suite 200
Astoria, NY 11105-2765
Phone (718) 777-7742
259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600
530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300
550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300
560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300
6915 Austin St
Forest Hills, NY 11375-4255
Phone (718) 544-5100
74 Kent St
Brooklyn, NY 11222-1517
Phone (516) 365-4949
9400 Bear Mountain TRL NE
Albuquerque, NM 87113-1335
Phone (212) 263-5230
9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unm Medical Group, Inc. | Current | Accepting new patients | |
| Unm Medical Group Inc | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- jrevels4164560@nychhc.direct-ci.com
- jrevels487624@nyumc.direct-ci.com
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Albuquerque, NM
- NPI 1831218627
-
- Community/Retail Pharmacy
- Albuquerque, NM
- NPI 1417330044
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Patchogue, NY
- NPI 1013724061
Hospital
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
-
- General Acute Care Hospital
- Patchogue, NY
- NPI 1831910355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1750674164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50095",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981455095",
"telephone_number": "206-520-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 LOMAS BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062719",
"telephone_number": "505-272-1476"
}
],
"practiceLocations": [
{
"address_1": "1959 NE Pacific St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "98195",
"country_code": "US",
"telephone_number": "206-598-7200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1959 NE Pacific St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "98195",
"country_code": "US",
"telephone_number": "206-598-7200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REVELS",
"first_name": "JONATHAN",
"middle_name": "W",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-17",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NM",
"license": "A-2207-19",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "OP60730003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750674164",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.