ELITE PREMIER MEDICAL CARE PLUS LLC.
NPI 1205531688
Family Medicine in Fair Lawn, NJ
About Elite Premier Medical Care Plus Llc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELITE PREMIER MEDICAL CARE PLUS LLC. (NPI 1205531688) is a healthcare organization registered as a family medicine in Fair Lawn, New Jersey and active in the NPI registry since April 2023. The organization lists Fred Revoredo, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elite Premier Medical Care Plus Llc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Elite Premier Medical Care Plus LLC., which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Elite Premier Medical Care Plus LLC.'s NPI number?
The NPI number for Elite Premier Medical Care Plus LLC. is 1205531688. It was assigned to this organization in the NPPES registry on April 4, 2023.
Where is Elite Premier Medical Care Plus LLC. located?
Elite Premier Medical Care Plus LLC. is located at 15-01 Broadway, Fair Lawn, NJ 07410. The listed phone number is (201) 773-4200.
What is Elite Premier Medical Care Plus LLC.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Elite Premier Medical Care Plus LLC. enrolled in Medicare?
Yes. Elite Premier Medical Care Plus LLC. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Elite Premier Medical Care Plus LLC.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Elite Premier Medical Care Plus LLC.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Elite Premier Medical Care Plus LLC. was last updated on July 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Elite Premier Medical Care Plus Llc. · NPI 1205531688
Family Medicine organization in Fair Lawn, New Jersey. Organization record, active in the CMS NPPES registry since April 4, 2023.
## Identity
- **NPI:** 1205531688 (Entity type: Organization)
- **Enumerated:** April 4, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Fred Revoredo, MD
## Practice location
- **Address:** 15-01 BROADWAY, Fair Lawn, NJ 07410-6003
- **Phone:** (201) 773-4200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 29, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1205531688) · Data from the CMS NPPES public registry.