VIDA REVIVAL MEDICAL CORPORATION
NPI 1780560870
Clinic/Center - Primary Care in Thousand Oaks, CA
About Vida Revival Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VIDA REVIVAL MEDICAL CORPORATION (NPI 1780560870) is a healthcare organization registered as a primary care in Thousand Oaks, California and active in the NPI registry since August 2025. The organization lists Diana Alavi, Md/ Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vida Revival Medical Corporation 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 Vida Revival Medical Corporation, 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 Vida Revival Medical Corporation's NPI number?
The NPI number for Vida Revival Medical Corporation is 1780560870. It was assigned to this organization in the NPPES registry on August 13, 2025.
Where is Vida Revival Medical Corporation located?
Vida Revival Medical Corporation is located at 3180 Willow Ln Ste 114, Thousand Oaks, CA 91361. The listed phone number is (818) 232-8432.
What is Vida Revival Medical Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Vida Revival Medical Corporation enrolled in Medicare?
Yes. Vida Revival Medical Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Vida Revival Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Vida Revival Medical Corporation. 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 Vida Revival Medical Corporation was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Vida Revival Medical Corporation · NPI 1780560870
Primary Care organization in Thousand Oaks, California. Organization record, active in the CMS NPPES registry since August 13, 2025.
## Identity
- **NPI:** 1780560870 (Entity type: Organization)
- **Enumerated:** August 13, 2025
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Diana Alavi, MD/ CEO
## Practice location
- **Address:** 3180 WILLOW LN STE 114, Thousand Oaks, CA 91361-4984
- **Phone:** (818) 232-8432 · **Fax:** (818) 232-8433
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1780560870) · Data from the CMS NPPES public registry.