Revitalize LLC
NPI 1417238015 · Internal Medicine Physician · Rockville, MD
Revitalize LLC is a Internal Medicine Physician organization in Rockville, MD (NPI 1417238015).
Provider details
- NPI number
- 1417238015
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Norton Fishman, Medical Director(301) 330-9430
- License
- H67624 (MD)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Optimal Health Physicians
Registry dates
- Enumerated
- 2011-09-09
- Last updated
- 2011-10-24
Frequently asked questions
- What is Revitalize LLC's NPI number?
- Revitalize LLC's National Provider Identifier (NPI) is 1417238015, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revitalize LLC?
- Revitalize LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Revitalize LLC located?
- Revitalize LLC's practice location on file with NPPES is 15235 Shady Grove Rd, Rockville, MD 20850-3234.
- What is Revitalize LLC's phone number?
- The practice phone number listed in the NPPES registry for Revitalize LLC is (301) 330-9430.
- Who is the authorized official for Revitalize LLC?
- The authorized official listed on Revitalize LLC's NPPES record is Norton Fishman, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revitalize LLC's NPI active?
- Yes — Revitalize LLC's NPI (1417238015) is active in the NPPES registry as of the last update on 2011-10-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.