REVITALIZE CNY, LLC
NPI 1396103438
Clinic/Center - Medical Specialty in Fayetteville, NY
NPI Status: Active since February 03, 2016
Contact Information
6800 E GENESEE ST
SUITE 1200
FAYETTEVILLE, NY
ZIP 13066
Phone: (315) 251-1234
Fax: (315) 251-1144
- Organization
- Clinic/Center
- Medical Specialty
- CLIA Number: 33D2115614
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 03-26-2027
About REVITALIZE CNY, LLC
This page provides the complete NPI Profile along with additional information for Revitalize Cny, Llc, a provider established in Fayetteville, New York operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1396103438 assigned on February 2016. The practitioner's primary taxonomy code is 261QM2500X with license number F335679 (NY). The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Theresa M. Setter Aprn-bc, Dcnp (Owner)
- NPI
- 1396103438
- Provider Name
- REVITALIZE CNY, LLC
- Entity Type
- Organization
- Location Address
- 6800 E GENESEE ST SUITE 1200 FAYETTEVILLE, NY 13066
- Location Phone
- (315) 251-1234
- Location Fax
- (315) 251-1144
- Mailing Address
- 6800 E GENESEE ST SUITE 1200 FAYETTEVILLE, NY 13066
- Mailing Phone
- (315) 251-1234
- Mailing Fax
- (315) 251-1144
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-03-2016
- Last Update Date
- 02-03-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Medical Specialty
- Taxonomy Code
- 261QM2500X
- Type
- Ambulatory Health Care Facilities
- License No.
- F335679
- License State
- NY
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| J400085712 | MEDICARE UPIN (02) | NY | |
| 3835536 | MEDICAID (05) | NY |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 33D2115614
- Facility Type
- Independent
- Certificate Effective Date
- July 12, 2022
- Certificate Expiration Date
- March 26, 2027
- Laboratory Director
- DR. THERESA M. SETTER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Revitalize Cny, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for REVITALIZE CNY, LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 9 | 6 | 1 | 0 | 3 | 4 | 3 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 2 | 0 | 6 | 4 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 2 + 0 + 6 + 4 + 6 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1396103438 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 15 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1790752780 | ROBERT CADY MD Individual | Orthopaedic Surgery | 6800 E GENESEE ST SUITE 1501 FAYETTEVILLE, NY 13066 (315) 671-0317 |
| 1932168358 | NICOLA ARGESE P.T. Individual | Physical Therapist | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 446-1057 |
| 1215980339 | MR. GEORGE BARRETT PT Individual | Physical Therapist | 6800 E GENESEE ST SUITE A FAYETTEVILLE, NY 13066 (315) 478-0380 |
| 1750387130 | CYNTHIA J TREMBLAY NP Individual | Nurse Practitioner (Family) | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 445-0003 |
| 1518301134 | SHEILA MCGUIRE NP Individual | Nurse Practitioner (Adult Health) | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 445-0003 |
| 1174940696 | MEDICAL WEIGHT LOSS OF NEW YORK, PLLC Organization | Family Medicine (Obesity Medicine) | 6800 E GENESEE ST SUITE 1501 FAYETTEVILLE, NY 13066 (315) 391-9390 |
| 1235527870 | JULIE C CANNIZZO N.P. Individual | Nurse Practitioner (Family) | 6800 E GENESEE ST SUITE 1501 FAYETTEVILLE, NY 13066 (315) 445-0003 |
| 1073076477 | DR. IRVING STERMAN MD Individual | Orthopaedic Surgery | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 474-8595 |
| 1982024204 | SYRACUSE ORTHOPEDIC SPECIALISTS, PC Organization | Orthopaedic Surgery | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 449-4118 |
| 1588256531 | BRYAN QUARTIER Individual | Physical Therapist | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 635-5000 |
| 1770241150 | JACOB S SPILLANE Individual | Physical Therapist | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 635-5000 |
| 1417356940 | JULIE R BERUBE DPT Individual | Physical Therapist | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 635-5000 |
| 1427778372 | JESSICA ORALLO MANALANG Individual | Physical Therapist | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 635-5000 |
| 1760101737 | CAITLIN SPINELLI Individual | Nurse Practitioner (Family) | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 445-0003 |
| 1619583945 | DEANNA MARIE DERRENBACKER PT Individual | Physical Therapist | 6800 E GENESEE ST FAYETTEVILLE, NY 13066 (315) 635-5000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396103438, enumerated in the NPI registry as an "organization" on February 03, 2016
The provider is located at 6800 E Genesee St Suite 1200 Fayetteville, Ny 13066 and the phone number is (315) 251-1234
This medical organization specializes in Clinic/Center with taxonomy code 261QM2500X with a focus in Medical Specialty
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 33D2115614 for a "independent" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on February 03, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.