FREDY JESUS REVILLA M.D.
NPI 1760418610
Psychiatry & Neurology - Neurology in Greenville, SC
NPI Status: Active since June 23, 2006
Contact Information
200 PATEWOOD DR STE B350
GREENVILLE, SC
ZIP 29615
Phone: (864) 454-4500
Fax: (864) 454-4505
- Individual
- Male
- Years of Experience 33
- Psychiatry & Neurology
- Neurology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About FREDY REVILLA
This page provides the complete NPI Profile along with additional information for Fredy Revilla, a provider established in Greenville, South Carolina with a medical specialization in Psychiatry & Neurology, focusing in neurology and more than 33 years of experience. The healthcare provider is registered in the NPI registry with number 1760418610 assigned on June 2006. The practitioner's primary taxonomy code is 2084N0400X with license number 37641 (SC). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1760418610
- Provider Name
- FREDY JESUS REVILLA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615
- Location Phone
- (864) 454-4500
- Location Fax
- (864) 454-4505
- Mailing Address
- 300 E MCBEE AVE FL 4 GREENVILLE, SC 29601
- Mailing Phone
- (864) 522-8603
- Medical School Name
- OTHER
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-23-2006
- Last Update Date
- 06-29-2021
- 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
Psychiatry & Neurology Neurology
- Taxonomy Code
- 2084N0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 37641
- License State
- SC
- Taxonomy Description
- A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 35083417 (OH) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue Reedy Bronze 1 - HMO
- Blue Reedy Bronze 2 - HMO
- Blue Reedy Gold 1 - HMO
- Blue Reedy Silver 1 - HMO
- Blue Reedy Silver 2 - HMO
- InHealth Basic 1 - HMO
- InHealth Basic 1 + Adult Vision - HMO
- InHealth Basic 2 - HMO
- InHealth Basic Plus Standard - HMO
- InHealth Basic Standard - HMO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
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.
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 |
---|---|---|---|
2463614 | MEDICAID (05) | OH | |
376417 | MEDICAID (05) | SC | |
P00113175 | OTHER (01) | OH | MEDICARE RAILROAD |
Medicare Participation & PECOS Enrollment Status
Fredy Revilla is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Fredy Revilla is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 5799671764
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20150216001032
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Medical/Surgical Supplies (DA000N)
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) (HCPCS:A4222)
2 DME suppliers used 13 Medicare Claims 364 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
2 DME suppliers used 16 Medicare Claims 16 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG000N)
Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml (HCPCS:J7340)
2 DME suppliers used 13 Medicare Claims 364 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box
Injection, onabotulinumtoxina, 1 unit
Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle
New patient office or other outpatient visit, 60-74 minutes
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 345 times for 221 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 38 times for 34 patientsThis procedure involves injecting a chemical into specific neck muscles, causing temporary paralysis. It's designed to alleviate symptoms related to nerve disorders. The voice box isn't affected, ensuring normal speech post-procedure.
This service was performed 42 times for 12 patientsOnabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
This service was performed 20,600 times for 22 patientsThis procedure involves a needle that measures the electrical activity in your muscles. A chemical is then injected to temporarily paralyze the nerve muscle. This helps in diagnosing and treating certain muscle or nerve conditions.
This service was performed 37 times for 12 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 20 times for 20 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.01 for a new patient copayment and $23.78 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 29615 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $124.04
- Minimum New Patient Price $53.57
- Maximum New Patient Price $163.84
- Average New Patient Copayment $31.01
- Minimum New Patient Copayment $13.39
- Maximum New Patient Copayment $40.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.12
- Minimum Established Patient Price $16.96
- Maximum Established Patient Price $133.52
- Average Established Patient Copayment $23.78
- Minimum Established Patient Copayment $4.24
- Maximum Established Patient Copayment $33.38
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Fredy Revilla is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL | 701 GROVE ROAD GREENVILLE, SC 29605 | (864) 455-7000 | Acute Care Hospitals |
Reviews for FREDY JESUS REVILLA M.D.
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 | 7 | 6 | 0 | 4 | 1 | 8 | 6 | 1 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 12 | 0 | 8 | 1 | 16 | 6 | 2 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 1 + 2 + 0 + 8 + 1 + 1 + 6 + 6 + 2 + 24 = 60 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1760418610 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1134645641 | SARAH JUNGMEE MCNIGHT NP Individual | Nurse Practitioner (Family) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1063778322 | KANIKA ARORA MD Individual | Psychiatry & Neurology (Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1043277676 | MRS. SUZANN H. HOBBS N.P. Individual | Nurse Practitioner (Family) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1548715238 | EMMA R HAYDEN PA-C Individual | Physician Assistant | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1629057534 | DR. PAULO L ZORTEA M.D. Individual | Psychiatry & Neurology (Vascular Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1922031848 | JOSEPH P HANNA MD Individual | Psychiatry & Neurology (Vascular Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1679097794 | LAUREN WALPOLE SCARBOROUGH FNP-C Individual | Nurse Practitioner (Family) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1578935904 | SARAH DENES MORRIS N.P. Individual | Nurse Practitioner (Acute Care) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1902313018 | NGAN KIM WARD Individual | Nurse Practitioner (Acute Care) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1235559352 | DR. VENKATACHALAM KUMAR VEERAPPAN M.D. Individual | Psychiatry & Neurology (Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1720417116 | CASSANDRA LYNN DRUMMOND FNP-BC Individual | Nurse Practitioner (Family) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1558779488 | ELENA RHIANON BLAS NP Individual | Nurse Practitioner (Acute Care) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1275973661 | DR. NARESH MULLAGURI M.D. Individual | Psychiatry & Neurology (Neurocritical Care) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1184912289 | DHANYA VIJAYAKUMAR M.D. Individual | Psychiatry & Neurology (Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1134516594 | DERY ANN MILLER M.D. Individual | Psychiatry & Neurology (Clinical Neurophysiology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1972947661 | DR. DAVID M KEREK M.D. Individual | Psychiatry & Neurology (Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1336690775 | ANNA N REID NP Individual | Nurse Practitioner (Family) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1629314836 | KATHERINE WILLETT DAHLBERG M.D. Individual | Psychiatry & Neurology (Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1770154106 | MRS. THERESA ANN VOKEY NP Individual | Nurse Practitioner | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
1346479532 | CHUN CHIN HUANG MD Individual | Psychiatry & Neurology (Neurology) | 200 PATEWOOD DR STE B350 GREENVILLE, SC 29615 (864) 454-4500 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760418610, enumerated in the NPI registry as an "individual" on June 23, 2006
The provider is located at 200 Patewood Dr Ste B350 Greenville, Sc 29615 and the phone number is (864) 454-4500
The provider's speciality is Psychiatry & Neurology with taxonomy code 2084N0400X with a focus in Neurology
The provider has more than 33 years of experience.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $124.04 with an average copayment of $31.01 for new patient appointments. Established patients should expect a typical charge of $95.12 and an average copayment of 23.78. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box, Injection, onabotulinumtoxina, 1 unit, Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle and New patient office or other outpatient visit, 60-74 minutes.
The practitioner is affiliated to the following hospital(s): PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on June 23, 2006. 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.