Andreas Frank Revelis, M.D.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

21829 Issued in OK

Practice address

10810 E 45TH St Ste 400
Tulsa, OK 74146-3806

Phone

(918) 742-7030

Fax

(918) 742-9958

NPI assigned

May 23, 2005

Last updated

Aug 7, 2020By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Pain ManagementAlso: Anesthesiology

Education

University of Oklahoma College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tulsa Spine & Specialty Hospital Hospital, Tulsa, OK, CCN 370216
• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: arevelis112668@ahs.direct-ci.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/TSSH/api/FHIR/R4
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Ahs Oklahoma Physician Group LLC

  dba Utica Park Clinic

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775
  Medicare reassignment Care Compare group NPD
• Ahs Oklahoma Physician Group, LLC

  dba Cushing Medical Specialist

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD
• Hatton Anesthesia LLC

  • Anesthesiology Physician
  • Tulsa, OK
  • NPI 1659922201
  NPD (past)
• Tulsa Spine & Specialty Hospital

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1033185293
  NPD (past)

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

• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Tulsa Spine & Specialty Hospital

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1033185293
  Care Compare affiliation

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1902809080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 E 45TH ST STE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741463806",
            "telephone_number": "918-742-7030",
            "fax_number": "918-742-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 E 45TH ST STE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741463806",
            "telephone_number": "918-742-7030",
            "fax_number": "918-742-9958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 S Wheeling Ave",
            "address_2": "Ste 600",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045645",
            "country_code": "US",
            "telephone_number": "918-742-7030",
            "fax_number": "918-742-9958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVELIS",
        "first_name": "ANDREAS",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OK",
            "license": "21829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Retkowski, COTA/L
• Nathan G Reusser, DO
• Leron Revan
• Revelation Medical LLC
• Revelation Medical of Tulsa LLC
• Reverence Counseling & Consulting
• Logan Revill, APRN
• Grayson Revilla
• Revive Counseling
• Glenn Ethan Patrick Rex

• Pain Medicine (Anesthesiology) Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Pain Medicine (Anesthesiology) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.