Revive Rehab Plus LLC
NPI 1154192474ActiveOrganization· Physical Therapist· Chantilly, VA
Physical Therapist in Chantilly, Virginia, registered in NPPES in January 2024. The authorized official on file is Kavya Reddy Punuru, PT, Managing Member. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice and part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1154192474 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 15, 2024 |
| Last updated in NPPES | Jan 15, 2024 |
| Certified by provider | Jan 15, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (DC); Part B Supplier - Physical/Occupational Therapy Group in Private Practice (VA) |
|---|
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