Iris Altagracia Castro-Revoredo, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

56984 Issued in GA

Practice address

601 S 8TH St
Griffin, GA 30224-4213

Phone

(770) 467-6314

Fax

(770) 467-6324

NPI assigned

Oct 10, 2006

Last updated

Dec 3, 2019By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal MedicineAlso: Hospice/Palliative Care

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

City of Hope Medical Group of Georgia LLCGroup PAC ID 4880841212, 137 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
• Southeastern Regional Medical Center, Inc Hospital, Newnan, GA, CCN 110233
• Fayetteville Center for Nursing & Healing LLC Nursing home, Fayetteville, GA, CCN 115360

Merit-based Incentive Payment System (MIPS)

Final score

79.74 of 100Reported as group

Quality

63.81

Promoting interoperability

100

Improvement activities

40

Cost

57.71

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• City of Hope Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Newnan, GA
  • NPI 1447520333
  Medicare reassignment Care Compare group NPD
• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381
  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823
  Medicare reassignment NPD
• Georgia Mso LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1952196164
  Medicare reassignment NPD
• Hardy Renew Wellness,LLC

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1952914368
  Medicare reassignment NPD
• Amor Home Care LLC

  • Home Health Agency
  • Fayetteville, GA
  • NPI 1306518394
  NPD Authorized official
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD
• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1659537165
  NPD
• Fayetteville Center for Nursing & Healing LLC

  • Skilled Nursing Facility
  • Fayetteville, GA
  • NPI 1760061840
  NPD (past)
• The New York and Presbyterian Hospital

  dba New-York-Presbyterian Pharmacy

  • Community/Retail Pharmacy
  • White Plains, NY
  • NPI 1457057226
  NPD (past)
• The New York and Presbyterian Hospital

  dba Ambulatory Care Network

  • Nutritionist
  • New York, NY
  • NPI 1891857025

  Internal Medicine

  NPD (past)

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

• Fayetteville Center for Nursing & Healing LLC

  • Skilled Nursing Facility
  • Fayetteville, GA
  • NPI 1760061840

  Nursing home

  Care Compare affiliation
• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation
• Southeastern Regional Medical Center, Inc.

  dba City of Hope Cancer Center Atlanta

  • General Acute Care Hospital
  • Newnan, GA
  • NPI 1235417288
  Care Compare affiliation

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1801984562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13957 WOOLSEY RD",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302282246",
            "telephone_number": "770-703-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244213",
            "telephone_number": "770-467-6314",
            "fax_number": "770-467-6324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13957 Woolsey Rd",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "GA",
            "postal_code": "302282246",
            "country_code": "US",
            "telephone_number": "770-703-6601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTRO-REVOREDO",
        "first_name": "IRIS",
        "middle_name": "ALTAGRACIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "056984",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "56984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "icastrorevoredo146622@directwellstar.org",
            "affiliation": "N",
            "address_1": "601 S 8th St",
            "city": "Griffin",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302244213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Careconnect Health, Inc (CareConnect Convenient Care)
• Careconnect Health, Inc. (CareConnect Urgent Care)
• Lanitra Lashai Carey, LPC
• Dothia Mazie Casey
• Nihal Eisa Cassady, M.D.
• Hannah Rae Cecil, FNP-C
• Cedar Trail Counseling
• Ceed Community Enrichment, LLC
• Dione Marie Centrella, PHARM.D.
• Abe Chab, DMD

• Hospitalist Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Hospitalist Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.

Verify at the official NPI Registry.