REVIVED SOUL MEDICAL PC
NPI 1821389941
Psychiatry & Neurology - Psychiatry in Brooklyn, NY
About Revived Soul Medical Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVED SOUL MEDICAL PC (NPI 1821389941) is a healthcare organization registered as a psychiatry in Brooklyn, New York and active in the NPI registry since April 2011. The organization lists Irina Kiblitsky, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Revived Soul Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
18Medicare enrollment records show 18 clinicians reassign Medicare billing to Revived Soul Medical PC, which bills Medicare for the services they deliver. Of these, 15 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (18)
New York, NY 10016
Hallandale Beach, FL 33009
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 Revived Soul Medical PC's NPI number?
The NPI number for Revived Soul Medical PC is 1821389941. It was assigned to this organization in the NPPES registry on April 23, 2011.
Where is Revived Soul Medical PC located?
Revived Soul Medical PC is located at 1901 Avenue P 1A, Brooklyn, NY 11229. The listed phone number is (718) 382-5060.
What is Revived Soul Medical PC's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Revived Soul Medical PC enrolled in Medicare?
Yes. Revived Soul Medical PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revived Soul Medical PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians in 3 Medicare specialties reassign their Medicare billing to Revived Soul Medical PC. 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. The largest specialties are Nurse Practitioner (10), Clinical Social Worker (4) and Psychiatry (4). Of these, 15 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 Revived Soul Medical PC was last updated on April 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Revived Soul Medical Pc · NPI 1821389941
Psychiatry organization in Brooklyn, New York. Organization record, active in the CMS NPPES registry since April 23, 2011.
## Identity
- **NPI:** 1821389941 (Entity type: Organization)
- **Enumerated:** April 23, 2011
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **Organization subpart:** No
- **Authorized official:** Irina Kiblitsky, OWNER
## Practice location
- **Address:** 1901 AVENUE P, 1A, Brooklyn, NY 11229-1342
- **Phone:** (718) 382-5060
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 18 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (10), Clinical Social Worker (4), Psychiatry (4); 15 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 23, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1821389941) · Data from the CMS NPPES public registry.