REVIVALIFE HEALTH PLLC
NPI 1255130621
Nurse Practitioner - Family in Deland, FL
About Revivalife Health Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVALIFE HEALTH PLLC (NPI 1255130621) is a healthcare organization registered as a family in Deland, Florida and active in the NPI registry since March 2025. The organization lists Emily Hidalgo, Managing Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
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)
Revivalife Health Pllc 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 Revivalife Health PLLC, 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 Revivalife Health PLLC's NPI number?
The NPI number for Revivalife Health PLLC is 1255130621. It was assigned to this organization in the NPPES registry on March 10, 2025.
Where is Revivalife Health PLLC located?
Revivalife Health PLLC is located at 100 E New York Ave Ste 103, Deland, FL 32724. The listed phone number is (407) 901-7215.
What is Revivalife Health PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Revivalife Health PLLC enrolled in Medicare?
Yes. Revivalife Health PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revivalife Health PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Revivalife Health PLLC. 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 Revivalife Health PLLC was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.
# Revivalife Health Pllc · NPI 1255130621
Family organization in Deland, Florida. Organization record, active in the CMS NPPES registry since March 10, 2025.
## Identity
- **NPI:** 1255130621 (Entity type: Organization)
- **Enumerated:** March 10, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Emily Hidalgo, MANAGING MEMBER
## Practice location
- **Address:** 100 E NEW YORK AVE STE 103, Deland, FL 32724-5576
- **Phone:** (407) 901-7215
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 5, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1255130621) · Data from the CMS NPPES public registry.