BAYSIDE SPORT & SPINE PLLC
NPI 1679374110
Chiropractor in St Petersburg, FL

Q: What is Bayside Sport & Spine PLLC's NPI number?

The NPI number for Bayside Sport & Spine PLLC is 1679374110. It was assigned to this organization in the NPPES registry on March 21, 2025. The provider is doing business as Sea Change Chiropractic.

Q: What is Bayside Sport & Spine PLLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since March 21, 2025

5415 4TH ST N, ST PETERSBURG, FL 33703(727) 521-4244 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 2, 2025, Mar 21, 2025 (2 updates tracked since 2025).

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About Bayside Sport & Spine Pllc NPPES

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

BAYSIDE SPORT & SPINE PLLC (NPI 1679374110), doing business as Sea Change Chiropractic, is a healthcare organization registered as a chiropractor in St Petersburg, Florida and active in the NPI registry since March 2025. The organization lists Ross J Revella, Owner/chiropractor, as its authorized official.

NPPES Registry Identity

NPI1679374110

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameBAYSIDE SPORT & SPINE PLLC

Location Address5415 4TH ST NSt Petersburg, FL 33703-2249

Mailing Address5415 4th St NSt Petersburg, FL 33703-2249 · (727) 521-4244

Phone(727) 521-4244

Organization SubpartNo

Authorized OfficialRoss J RevellaOwner/chiropractor · (330) 261-3802

Enumeration DateMarch 21, 2025

Last NPPES UpdateJuly 2, 20252 updates tracked since enumeration

NPPES CertifiedJuly 2, 2025

✔ NPI 1679374110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

5415 4TH ST N, St Petersburg, FL 33703

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Other Names 1

Doing Business AsSea Change Chiropractic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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)

Bayside Sport & Spine Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Bayside Sport & Spine PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Ross Revella, DC

Chiropractic

NPI 1548818917

5415 4TH ST N
St Petersburg, FL 33703

(727) 521-4244

✔ Accepts MedicareSame address

Bryan Karn, DC

Chiropractic

NPI 1356110530

1700 DR MARTIN LUTHER KING JR ST N
St Petersburg, FL 33704

(727) 822-1555

✔ Accepts Medicare2.4 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 Bayside Sport & Spine PLLC's NPI number?

The NPI number for Bayside Sport & Spine PLLC is 1679374110. It was assigned to this organization in the NPPES registry on March 21, 2025. The provider is doing business as Sea Change Chiropractic.

Where is Bayside Sport & Spine PLLC located?

Bayside Sport & Spine PLLC is located at 5415 4th St N, St Petersburg, FL 33703. The listed phone number is (727) 521-4244.

What is Bayside Sport & Spine PLLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Bayside Sport & Spine PLLC enrolled in Medicare?

Yes. Bayside Sport & Spine PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bayside Sport & Spine PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to Bayside Sport & Spine 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. Of these, 1 practice at this address and 2 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 Bayside Sport & Spine PLLC was last updated on July 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.