Nickolas Alexander Reviello

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062756 Issued in PA

Practice address

334 Main St Ste 1
Dickson City, PA 18519-1668

Phone

(570) 307-1767

NPI assigned

Aug 24, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, NC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unc Physicians Group Practices II LLCGroup PAC ID 2466865944, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital, Raleigh, NC, CCN 340114
• Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nreviello1438059@direct.unc.nchie.net
• Direct secure messaging: nickolasreviello@jps.medentdirect.com

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.

• Unc Physicians Group Practices II, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Cary, NC
  • NPI 1053919183
  Medicare reassignment Care Compare group NPD
• Hazleton Professional Services

  • Internal Medicine Physician
  • Hazleton, PA
  • NPI 1952464638
  Medicare reassignment NPD
• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Obstetrics & Gynecology Physician
  • Allentown, PA
  • NPI 1437248598
  NPD

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

• Wilkes Barre Hospital Company LLC

  • Clinic/Center
  • Wilkes Barre, PA
  • NPI 1053554378

  Hospital

  Care Compare affiliation
• Wilkes Barre Hospital Company LLC

  • General Acute Care Hospital
  • Wilkes Barre, PA
  • NPI 1255585303
  Care Compare affiliation
• Rex Hospital Inc.

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1821765272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 DOUGLAS DR",
            "city": "COVINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184247825",
            "telephone_number": "570-702-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 MAIN ST STE 1",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191668",
            "telephone_number": "570-307-1767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 S Main St",
            "address_purpose": "LOCATION",
            "city": "Holly Springs",
            "state": "NC",
            "postal_code": "275408907",
            "country_code": "US",
            "telephone_number": "919-346-8651",
            "fax_number": "919-557-6084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVIELLO",
        "first_name": "NICKOLAS",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nreviello1438059@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "851 S Main St",
            "city": "Holly Springs",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275408907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rabel Furniture Inc.
• Navindra Ramharack, MD
• Dylan Ratzin
• Kathleen Reap, P.T.
• Samantha Mary Reed
• John T Rich, M.D.
• Abigail Rieder, BS
• Stephanie Robinson
• Nicholas Rocco, CRNA
• Ashley Marie Romanko, PA-C

• Physician Assistant in Dickson City, PA
• Providers in Dickson City, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.