Matthew Charles Revilla, PA-C is a medicare enrolled "Physician Assistant" physician in Palmetto, Georgia. He graduated from medical school in 2019 and has 6 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice The Emory Clinic Inc and his current practice location is
507 Park St, Palmetto, Georgia. You can reach out to his office (for appointments etc.) via phone at
(770) 463-4644.
Matthew Charles Revilla is licensed to practice in Georgia (license number 9684) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1821617036.
Physician's Profile
| Full Name | Matthew Charles Revilla |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 6 Years |
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| Location | 507 Park St, Palmetto, Georgia |
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| Accepts Medicare Assignments | Yes. He 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:
- Matthew Charles Revilla graduated from medical school in 2019
NPI Data:
- NPI Number: 1821617036
- Provider Enumeration Date: 04/09/2020
- Last Update Date: 08/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 6204230543
- Enrollment ID: I20250121002397
Medical Identifiers
Medical identifiers for Matthew Charles Revilla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821617036 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QA0505X | Family Medicine - Adult Medicine | 9684 (Georgia) | Secondary |
| 363A00000X | Physician Assistant | 9684 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| The Emory Clinic Inc | 8820901408 | 3084 |
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. Matthew Charles Revilla 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 |
|---|
Matthew Charles Revilla, PA-C
643 Main St,
Palmetto, GA 30268-1138
Ph: (404) 929-8824 | Matthew Charles Revilla, PA-C
507 Park St,
Palmetto, GA 30268-1007
Ph: (770) 463-4644 |
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