Casey S Revenko, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA56633 Issued in CA

Practice address

350 30TH St Ste 100
Oakland, CA 94609-3422

Phone

(510) 204-1844

NPI assigned

May 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Concord, CA, CCN 057004
• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
• Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

Merit-based Incentive Payment System (MIPS)

Final score

68.96 of 100Reported as group

Quality

73.9

Promoting interoperability

100

Improvement activities

0

Cost

72.62

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crevenko455421@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• California Sports and Orthopaedic

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Orinda, CA
  • NPI 1649433962
  Medicare reassignment
• California Sports and Orthopaedic

  • Orthopaedic Surgery Physician
  • Oakland, CA
  • NPI 1619482387
  NPD
• Sutter Bay Medical Foundation

  dba Sutter East Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Orinda, CA
  • NPI 1366898538
  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Alta Bates Summit Medical Center

  dba Merritt Peralta Insititute

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1043358542
  NPD (past)
• California Pacific Medical Group, Inc.

  dba Brown & Toland Medical Group

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• California Sports and Orthopaedic Institute Inc

  • Orthopaedic Surgery Physician
  • Berkeley, CA
  • NPI 1841379831
  NPD (past)
• Eden Medical Center/San Leandro Hospital Campus

  dba San Leandro Hospital

  • Rehabilitation Hospital Unit
  • San Leandro, CA
  • NPI 1679523633
  NPD (past)
• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  NPD (past)
• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Summit Campus

  • Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1194171371
  NPD (past)
• Sutter East Bay Medical Foundation

  • Clinical Medical Laboratory
  • Berkeley, CA
  • NPI 1831381623
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Bay Hospitals

  dba Eden Medical Center

  • General Acute Care Hospital
  • Castro Valley, CA
  • NPI 1063812907
  Care Compare affiliation
• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Summit Campus

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477
  Care Compare affiliation
• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Alta Bates Campus

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  dba Sutter Care at Home

  • Home Health Agency
  • Concord, CA
  • NPI 1083643944
  Care Compare affiliation

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1790341618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276950",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958276950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST STE 100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093422",
            "telephone_number": "510-204-1844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2999 Regent St Ste 225",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052117",
            "country_code": "US",
            "telephone_number": "510-704-7760",
            "fax_number": "510-704-7765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVENKO",
        "first_name": "CASEY",
        "middle_name": "S",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "PA56633",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rettner, M.S.
• Cecilia A Reus, MA
• Quin Reuss
• Reveal Diagnostics LLC
• Anthony J. Revelli, O.D.
• Camice Jeanette Revier, B.S.
• Yesenia Revuelta-Ozuna, PHARM.D.
• Jorge Ramos Revuelta
• Maricela Reyes Reynaga
• Andrea Guadalupe Reyes Solorio

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.