Revive Rehab Inc - Medicare Physical Therapist in Jacksonville, FL

Revive Rehab Inc is a medicare enrolled "Physical Therapist" provider in Jacksonville, Florida. Their current practice location is 4745 Sutton Park Ct Ste 403, Jacksonville, Florida. You can reach out to their office (for appointments etc.) via phone at (904) 371-4649.

Revive Rehab Inc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Revive Rehab Inc is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1962734210.

Contact Information

Revive Rehab Inc
4745 Sutton Park Ct Ste 403,
Jacksonville, FL 32224-0255
(904) 371-4649
(888) 393-1099

Map and Direction




Healthcare Provider's Profile

Full NameRevive Rehab Inc
TypeFacility
SpecialityPhysical Therapist
Location4745 Sutton Park Ct Ste 403, Jacksonville, Florida
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1962734210
  • Provider Enumeration Date: 02/10/2010
  • Last Update Date: 05/19/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 8527197441
  • Enrollment ID: O20100602000164

Medical Identifiers

Medical identifiers for Revive Rehab Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962734210NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist (* (Not Available))Primary
225X00000XOccupational Therapist (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Revive Rehab Inc acts as a billing entity for following providers:
Provider NameDarly Thoppil
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1952633208
PECOS PAC ID: 4981733805
Enrollment ID: I20100622000105
Provider NameDavid A Shelton
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1962485656
PECOS PAC ID: 0446205504
Enrollment ID: I20111214000864
Provider NameRobert Stephen Woodward
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1013193143
PECOS PAC ID: 6800168089
Enrollment ID: I20170823001373
Provider NameChristine Maximos
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1811451073
PECOS PAC ID: 8123452059
Enrollment ID: I20191230001967
Provider NameDawn Lee Rudolph
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1437769478
PECOS PAC ID: 4789009671
Enrollment ID: I20200810001866
Provider NameTara Thompson Merlo
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1497909527
PECOS PAC ID: 4587720347
Enrollment ID: I20220721000865
Provider NameKaterina Nicole Benedict
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1255105466
PECOS PAC ID: 2264880665
Enrollment ID: I20231125000059
Provider NameMallory R Massey
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1548097439
PECOS PAC ID: 0648792069
Enrollment ID: I20250314001669

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. Revive Rehab Inc 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 AddressPractice Location Address
Revive Rehab Inc
151 Sawgrass Corners Dr, Suite # 117,
Ponte Vedra Beach, FL 32082-3553

Ph: (904) 472-8846
Revive Rehab Inc
4745 Sutton Park Ct Ste 403,
Jacksonville, FL 32224-0255

Ph: (904) 371-4649

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.