Revive Rehab Services LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REVIVE REHAB SERVICES LLC

Practice address

623 W Union Blvd Ste 1B
Bethlehem, PA 18018-3708

Phone

(484) 891-0608

Fax

(484) 283-2232

NPI assigned

Jul 14, 2012

Last updated

Feb 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Muhammad JasimNPI 1902199219

Title

Owner

Phone

(484) 891-0608

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Muhammad Jasim, PT

  • Physical Therapist
  • Bethlehem, PA
  • NPI 1902199219
  Medicare reassignment NPD Authorized official
• Dareen Alzoubi

  • Physical Therapist
  • Bethlehem, PA
  • NPI 1104695220
  NPD

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

{
    "created_epoch": "1342224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1922353143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 YORKSHIRE DR",
            "city": "BREINIGSVILLE",
            "state": "PA",
            "postal_code": "180311544",
            "telephone_number": "484-891-0608",
            "fax_number": "484-283-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 W UNION BLVD STE 1B",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180183708",
            "telephone_number": "484-891-0608",
            "fax_number": "484-283-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE REHAB SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-14",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "JASIM",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-891-0608"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102786220",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Ressler
• Stacy Lynn Restucci
• Katherine Ann Restuccia, PSY.D.
• Joy M. Reszek, M.S. CCC SLP
• Hilary Reviello, PA-C
• Sally Ann Rex, D.O.
• Lea Reyes, MD
• Marieanjelee Reyes
• Nylah Charlize Reyes
• Yesenia Reyes

• Physical Therapy Clinic/Center in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Physical Therapy Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.