Revitawound Incorporated
NPI 1538982533ActiveOrganization· Internal Medicine· Burbank, CA
Internal Medicine in Burbank, California, registered in NPPES in November 2024. The authorized official on file is Jennifer Mata, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1538982533 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 7, 2024 |
| Last updated in NPPES | Nov 19, 2024 |
| Certified by provider | Nov 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
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 - Clinic/Group Practice (CA) |
|---|
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