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REVOLUTIONARY CARE CLINIC LLC
NPI 1457088437
Family Medicine in Delray Beach, FL

Active since August 01, 2022
1690 S CONGRESS AVE STE 205B, DELRAY BEACH, FL 33445(833) 854-3131(888) 979-8674 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 9, 2023, Aug 1, 2022 (2 updates tracked since 2022).

About Revolutionary Care Clinic Llc NPPES

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

REVOLUTIONARY CARE CLINIC LLC (NPI 1457088437) is a healthcare organization registered as a family medicine in Delray Beach, Florida and active in the NPI registry since August 2022. The organization lists Jonathan Cordero, Owner, as its authorized official.

NPPES Registry Identity

NPI1457088437
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREVOLUTIONARY CARE CLINIC LLC
Location Address1690 S CONGRESS AVE STE 205BDelray Beach, FL 33445-6327
Mailing Address1690 S Congress Ave Ste 205bDelray Beach, FL 33445-6327 · (833) 854-3131 · Fax (888) 979-8674
Phone(833) 854-3131
Fax(888) 979-8674
Organization SubpartNo
Authorized OfficialJonathan CorderoOwner · (833) 854-3131
Enumeration DateAugust 1, 2022
Last NPPES UpdateAugust 1, 20232 updates tracked since enumeration
NPPES CertifiedAugust 1, 2023
✔ NPI 1457088437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
1690 S CONGRESS AVE STE 205B, Delray Beach, FL 33445
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revolutionary Care Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Revolutionary Care Clinic LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Deborah Thompson, FNP-BC
Nurse Practitioner
NPI 1619335205
20423 STATE ROAD 7 STE 28
Boca Raton, FL 33498
(561) 617-4650
✔ PECOS✔ Accepts Medicare8.5 mi
Steven Licata, DO
Osteopathic Manipulative Medicine
NPI 1508874439
4109 N FEDERAL HWY
Ft Lauderdale, FL 33308
(954) 563-2707
✔ PECOS✔ Accepts Medicare18 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 Revolutionary Care Clinic LLC's NPI number?

The NPI number for Revolutionary Care Clinic LLC is 1457088437. It was assigned to this organization in the NPPES registry on August 1, 2022.

Where is Revolutionary Care Clinic LLC located?

Revolutionary Care Clinic LLC is located at 1690 S Congress Ave Ste 205B, Delray Beach, FL 33445. The listed phone number is (833) 854-3131.

What is Revolutionary Care Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Revolutionary Care Clinic LLC enrolled in Medicare?

Yes. Revolutionary Care Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revolutionary Care Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Revolutionary Care Clinic LLC, in Nurse Practitioner and Osteopathic Manipulative Medicine. 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 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 Revolutionary Care Clinic LLC was last updated on August 1, 2023. 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.