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MATTHEW CHARLES REVILLA PA-C
NPI 1821617036
Physician Assistant in Palmetto, GA

Active since April 09, 2020PECOS EnrolledAccepts Medicare Assignment
507 PARK ST, PALMETTO, GA 30268(770) 463-4644 Get Directions Write a Review

NPPES record last updated: August 27, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 27, 2021, Apr 9, 2020 (2 updates tracked since 2020).

About Matthew Charles Revilla Pa-c NPPES

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

MATTHEW CHARLES REVILLA PA-C (NPI 1821617036) is an individual physician assistant in Palmetto, Georgia, licensed in Georgia (9684) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital Midtown, and maintains a secondary practice location in Atlanta.

NPPES Registry Identity

NPI1821617036
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMATTHEW CHARLES REVILLACredential: PA-C
Location Address507 PARK STPalmetto, GA 30268-1007
Mailing Address643 Main StPalmetto, GA 30268-1138 · (404) 929-8824
Phone(770) 463-4644
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateApril 9, 2020
Last NPPES UpdateAugust 27, 20212 updates tracked since enumeration
NPPES CertifiedAugust 27, 2021
✔ NPI 1821617036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in GA · 9684
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X · License 9684 (GA)
507 PARK ST, Palmetto, GA 30268
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Secondary Practice Location 1

Location 12584 Patrick Ct SEAtlanta, GA 30317-3023 · Phone (252) 414-8145

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Matthew Charles Revilla Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204230543
PECOS Enrollment IDI20250121002397
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30268 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

LYZETTE SANTIAGO RODRIGUEZ LPC
Counselor (Professional)
507 PARK ST
PALMETTO, GA 30268
Fulton County (770) 358-5252
ALANNA PERLIN MD
Family Medicine
507 PARK ST
PALMETTO, GA 30268
Fulton County (770) 463-4644
PALMETTO HEALTH COUNCIL, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
507 PARK ST
PALMETTO, GA 30268
Fulton County (404) 929-8824

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 Matthew Revilla's NPI number?

The NPI number for Matthew Revilla is 1821617036. It was assigned to this individual provider in the NPPES registry on April 9, 2020.

Where is Matthew Revilla located?

Matthew Revilla practices at 507 Park St, Palmetto, GA 30268. The listed phone number is (770) 463-4644.

What is Matthew Revilla's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Matthew Revilla enrolled in Medicare?

Yes. Matthew Revilla is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Matthew Revilla accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Matthew Revilla as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Matthew Revilla affiliated with any hospitals?

According to CMS data, Matthew Revilla is affiliated with Emory University Hospital Midtown.

When was this NPI record last updated?

The NPPES record for Matthew Revilla was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.