REVIVE MEDICAL & AESTHETIC CLINIC
NPI 1104536358
Clinic/Center - Primary Care in Greenbelt, MD
About Revive Medical & Aesthetic Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVE MEDICAL & AESTHETIC CLINIC (NPI 1104536358) is a healthcare organization registered as a primary care in Greenbelt, Maryland and active in the NPI registry since November 2022. The organization lists Florence Ukenye, Clinical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Revive Medical & Aesthetic Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Revive Medical & Aesthetic Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Revive Medical & Aesthetic Clinic's NPI number?
The NPI number for Revive Medical & Aesthetic Clinic is 1104536358. It was assigned to this organization in the NPPES registry on November 29, 2022.
Where is Revive Medical & Aesthetic Clinic located?
Revive Medical & Aesthetic Clinic is located at 7313 Hanover Pkwy Ste A, Greenbelt, MD 20770. The listed phone number is (301) 412-5522.
What is Revive Medical & Aesthetic Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Revive Medical & Aesthetic Clinic enrolled in Medicare?
Yes. Revive Medical & Aesthetic Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revive Medical & Aesthetic Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Revive Medical & Aesthetic Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Revive Medical & Aesthetic Clinic was last updated on November 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Revive Medical & Aesthetic Clinic · NPI 1104536358
Primary Care organization in Greenbelt, Maryland. Organization record, active in the CMS NPPES registry since November 29, 2022.
## Identity
- **NPI:** 1104536358 (Entity type: Organization)
- **Enumerated:** November 29, 2022
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Florence Ukenye, CLINICAL DIRECTOR
## Practice location
- **Address:** 7313 HANOVER PKWY STE A, Greenbelt, MD 20770-3667
- **Phone:** (301) 412-5522 · **Fax:** (301) 498-7436
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 29, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1104536358) · Data from the CMS NPPES public registry.