Gadi Asher Revivo, D.O.

Primary specialty

Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X

License

036-104471 Issued in IL

Practice address

355 E Erie St
Chicago, IL 60611-3167

Phone

(312) 238-1000

Fax

(312) 238-1208

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Physical Medicine and RehabilitationAlso: Interventional Pain Management

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Services RicGroup PAC ID 4880598978, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shirley Ryan Abilitylab Inpatient rehabilitation facility, Chicago, IL, CCN 143026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: grevivo209014@uchospital.direct-ci.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.

• Medical Services Ric

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1659306587
  Medicare reassignment Care Compare group NPD
• Rehabilitation Institute of Chicago

  dba Shirley Ryan AbilityLab

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1205879095

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  Medicare reassignment NPD
• The University of Chicago Medical Center

  dba UCMC Pharmacy Services

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Rehabilitation Institute of Chicago

  dba Shirley Ryan AbilityLab

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1205879095

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1922179787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113167",
            "telephone_number": "312-238-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113167",
            "telephone_number": "312-238-1000",
            "fax_number": "312-238-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVIVO",
        "first_name": "GADI",
        "middle_name": "ASHER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-104471",
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "IL",
            "license": "036-104471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104471-1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grevivo@direct.ric.og",
            "affiliation": "N",
            "endpointDescription": "Shirley Ryan AbilityLab",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "referrals",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "xml",
            "address_1": "355 E Erie St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606113167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Revital Chiropractic & Wellness PLLC
• Revitalize IV Solutions, LLC
• Revival Therapy & Wellness Inc (Megan Escutia Therapy)
• Revive Chiropractic
• Revive Relationship Therapy Inc.
• Revolution Counseling and Wellness LLC
• Revolution Health Systems
• Revolution Physical Therapy Weight Loss
• Revolution PTWL LLC (Revolution Physical Therapy Weight Loss)
• Reweave Therapy PLLC

• Pediatric Rehabilitation Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Rehabilitation Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.