Casey S Revenko, PHYSICIAN ASSISTANT is a medicare enrolled "Physician Assistant" physician in Oakland, California. She graduated from medical school in 2019 and has 6 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Sutter Bay Medical Foundation and her current practice location is
350 30th St Ste 100, Oakland, California. You can reach out to her office (for appointments etc.) via phone at
(510) 204-1844.
Casey S Revenko is licensed to practice in California (license number PA56633) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1790341618.
Physician's Profile
| Full Name | Casey S Revenko |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 6 Years |
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| Location | 350 30th St Ste 100, Oakland, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Casey S Revenko graduated from medical school in 2019
NPI Data:
- NPI Number: 1790341618
- Provider Enumeration Date: 05/15/2019
- Last Update Date: 12/31/2024
Medicare PECOS Information:
- PECOS PAC ID: 6204160377
- Enrollment ID: I20190624001105
Medical Identifiers
Medical identifiers for Casey S Revenko such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790341618 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207XX0005X | Orthopaedic Surgery - Sports Medicine | PA56633 (California) | Secondary |
| 363A00000X | Physician Assistant | PA56633 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Sutter Bay Medical Foundation | 4284538778 | 3318 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Casey S Revenko is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Casey S Revenko, PHYSICIAN ASSISTANT
Po Box 276950,
Sacramento, CA 95827-6950
Ph: () - | Casey S Revenko, PHYSICIAN ASSISTANT
350 30th St Ste 100,
Oakland, CA 94609-3422
Ph: (510) 204-1844 |
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