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REVASCMEDPROFESSIONAL NJ LLC
NPI 1154078202
Internal Medicine - Interventional Cardiology in Marlton, NJ

Active since March 08, 2022
525 ROUTE 73 N STE 117, MARLTON, NJ 08053(215) 575-5906(215) 392-7992 Get Directions Write a Review

NPPES record last updated: March 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Revascmedprofessional Nj Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVASCMEDPROFESSIONAL NJ LLC (NPI 1154078202), doing business as Revamp, is a healthcare organization registered as an interventional cardiology in Marlton, New Jersey and active in the NPI registry since March 2022. The organization lists Jon C George, Owner, as its authorized official.

NPPES Registry Identity

NPI1154078202
Entity TypeOrganization
Primary Taxonomy207RI0011X
Legal Business NameREVASCMEDPROFESSIONAL NJ LLC
Location Address525 ROUTE 73 N STE 117Marlton, NJ 08053-3422
Mailing Address525 Route 73 N Ste 117Marlton, NJ 08053-3422 · (215) 575-5906 · Fax (215) 392-7992
Phone(215) 575-5906
Fax(215) 392-7992
Organization SubpartNo
Authorized OfficialJon C GeorgeOwner · (215) 575-5906
Enumeration DateMarch 8, 2022
NPPES CertifiedMarch 8, 2022
✔ NPI 1154078202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
525 ROUTE 73 N STE 117, Marlton, NJ 08053
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Other Names 1

Doing Business AsRevamp

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revascmedprofessional Nj Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Revascmedprofessional Nj LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Vincent Varghese, D.O.
Cardiovascular Disease (Cardiology)
NPI 1316145808
5 GREENTREE CENTER SUITE 117
Marlton, NJ 08053
(609) 820-2430
✔ PECOS✔ Accepts Medicare2.2 mi
Courtney Destefano
Nurse Practitioner
NPI 1780219410
5 GREENTREE CENTER SUITE 117
Marlton, NJ 08053
(856) 528-7082
✔ PECOS✔ Accepts Medicare2.4 mi
Jon George, MD
Cardiovascular Disease (Cardiology)
NPI 1992746721
2418 E YORK ST
Philadelphia, PA 19125
(215) 575-5906
✔ PECOS✔ Accepts Medicare13 mi

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 Revascmedprofessional Nj LLC's NPI number?

The NPI number for Revascmedprofessional Nj LLC is 1154078202. It was assigned to this organization in the NPPES registry on March 8, 2022. The provider is doing business as Revamp.

Where is Revascmedprofessional Nj LLC located?

Revascmedprofessional Nj LLC is located at 525 Route 73 N Ste 117, Marlton, NJ 08053. The listed phone number is (215) 575-5906.

What is Revascmedprofessional Nj LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Revascmedprofessional Nj LLC enrolled in Medicare?

Yes. Revascmedprofessional Nj LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revascmedprofessional Nj LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Revascmedprofessional Nj LLC, in Cardiovascular Disease (Cardiology) and Nurse Practitioner. 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, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Revascmedprofessional Nj LLC was last updated on March 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.