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CLINICA REVIVE SALUD PLLC
NPI 1750003323
Clinic/Center - Primary Care in Phoenix, AZ

Active since September 12, 2022CLIA 03D2249681 · Waiver
6524 W INDIAN SCHOOL RD STE A, PHOENIX, AZ 85033(602) 892-0799(602) 892-0828 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 1, 2024, Dec 6, 2023, Sep 12, 2022 (3 updates tracked since 2022).

About Clinica Revive Salud Pllc NPPES

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

CLINICA REVIVE SALUD PLLC (NPI 1750003323) is a healthcare organization registered as a primary care in Phoenix, Arizona and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through January 20, 2028 and lists Nubia C Lomeli, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1750003323
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCLINICA REVIVE SALUD PLLC
Location Address6524 W INDIAN SCHOOL RD STE APhoenix, AZ 85033-3329
Mailing Address6524 W Indian School Rd Ste APhoenix, AZ 85033-3329 · (602) 892-0799 · Fax (602) 892-0828
Phone(602) 892-0799
Fax(602) 892-0828
Organization SubpartNo
Authorized OfficialNubia C LomeliMedical Director · (602) 892-0799
Enumeration DateSeptember 12, 2022
Last NPPES UpdateApril 1, 20243 updates tracked since enumeration
NPPES CertifiedApril 1, 2024
✔ NPI 1750003323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
6524 W INDIAN SCHOOL RD STE A, Phoenix, AZ 85033
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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)

Clinica Revive Salud Pllc 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 Clinica Revive Salud PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Paula Hernandez, DNP, FNP-C
Nurse Practitioner
NPI 1316559289
6524 W INDIAN SCHOOL RD STE A
Phoenix, AZ 85033
(602) 892-0799
✔ PECOS✔ Accepts MedicareSame address
Nubia Lomeli, DNP, FNP-C
Nurse Practitioner
NPI 1619328374
6524 W INDIAN SCHOOL RD STE A
Phoenix, AZ 85033
(602) 892-0799
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2249681

Clinica Revive Salud, PLLC · Phoenix, AZ
Active · expires Jan 20, 2028
CLIA Number03D2249681
Laboratory TypePhysician Office
Certificate Effective DateJanuary 21, 2026
Certificate Expiration DateJanuary 20, 2028
Laboratory DirectorNubia Lomeli
Laboratory Phone(602) 892-0799
Laboratory LocationClinica Revive Salud, PLLC6524 W Indian School Rd Ste A, Phoenix, AZ 85033
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Clinica Revive Salud PLLC's NPI number?

The NPI number for Clinica Revive Salud PLLC is 1750003323. It was assigned to this organization in the NPPES registry on September 12, 2022.

Where is Clinica Revive Salud PLLC located?

Clinica Revive Salud PLLC is located at 6524 W Indian School Rd Ste A, Phoenix, AZ 85033. The listed phone number is (602) 892-0799.

What is Clinica Revive Salud PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Clinica Revive Salud PLLC enrolled in Medicare?

Yes. Clinica Revive Salud PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Clinica Revive Salud PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Clinica Revive Salud 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, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Clinica Revive Salud PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2249681) is associated with this NPI, valid through January 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clinica Revive Salud PLLC was last updated on April 1, 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.