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MS. JENNIFER ALICEA REVOREDO PA
NPI 1801239363
Physician Assistant - Medical in South Orange, NJ

Active since April 15, 2013PECOS Enrolled
20 VALLEY ST STE 320, SOUTH ORANGE, NJ 07079(973) 313-1113 Get Directions Write a Review

NPPES record last updated: March 7, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Jennifer Alicea Revoredo Pa NPPES

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

MS. JENNIFER ALICEA REVOREDO PA (NPI 1801239363) is an individual medical provider in South Orange, New Jersey, licensed in New Jersey (25MP00304400) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801239363
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMS. JENNIFER ALICEA REVOREDOCredential: PA
Location Address20 VALLEY ST STE 320South Orange, NJ 07079-2881
Mailing Address20 Valley St Ste 320South Orange, NJ 07079-2881 · (973) 313-1113
Phone(973) 313-1113
Sole ProprietorNo
Enumeration DateApril 15, 2013
Last NPPES UpdateMarch 7, 2017
✔ NPI 1801239363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NJ · 25MP00304400
20 VALLEY ST STE 320, South Orange, NJ 07079
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Jennifer Alicea Revoredo Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
218 services215 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
119 services118 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
44 services42 patients

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ONEKA EDWARDS APN
Nurse Practitioner (Family)
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079
Essex County (973) 313-1113
SAMANTHA R MINOTT
Nurse Practitioner (Family)
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079
Essex County (973) 313-1113
MRS. ASHLYNE NICKY MEJIA NP
Nurse Practitioner (Family)
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079
Essex County (973) 313-1113
CHUKWUNWIKE P OKAFOR MD
Family Medicine (Sports Medicine)
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079
Essex County (973) 313-1113
SHYLA IMANI KISSOON PA-C
Physician Assistant
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079
Essex County (973) 313-1113
PRISCILLIA ANGIE ASSALE NP
Nurse Practitioner (Primary Care)
20 VALLEY ST STE 320
SOUTH ORANGE, NJ 07079
Essex County (973) 313-1113

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 Jennifer Revoredo's NPI number?

The NPI number for Jennifer Revoredo is 1801239363. It was assigned to this individual provider in the NPPES registry on April 15, 2013.

Where is Jennifer Revoredo located?

Jennifer Revoredo practices at 20 Valley St Ste 320, South Orange, NJ 07079. The listed phone number is (973) 313-1113.

What is Jennifer Revoredo's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jennifer Revoredo enrolled in Medicare?

Yes. Jennifer Revoredo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jennifer Revoredo was last updated on March 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.