Revive Pathway
NPI 1962117440 · Substance Use Disorder Rehabilitation Clinic/Center · El Cajon, CA
Enrolled with Medicare as Part B Supplier - Opioid Treatment Program (otp) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revive Pathway is a Substance Use Disorder Rehabilitation Clinic/Center organization in El Cajon, CA (NPI 1962117440).
Provider details
- NPI number
- 1962117440
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Judson Lea, Coo(619) 841-1310
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
- General Practice Physician208D00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 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
Registry dates
- Enumerated
- 2023-01-18
- Last updated
- 2026-05-06
- Certified
- 2026-05-06
Frequently asked questions
- What is Revive Pathway's NPI number?
- Revive Pathway's National Provider Identifier (NPI) is 1962117440, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revive Pathway?
- Revive Pathway is classified in the NPPES registry as Substance Use Disorder Rehabilitation Clinic/Center (Ambulatory Health Care Facilities).
- Where is Revive Pathway located?
- Revive Pathway's practice location on file with NPPES is 1240 Broadway, El Cajon, CA 92021-4994.
- What is Revive Pathway's phone number?
- The practice phone number listed in the NPPES registry for Revive Pathway is (619) 841-1310.
- Does Revive Pathway accept Medicare?
- Revive Pathway is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Revive Pathway?
- The authorized official listed on Revive Pathway's NPPES record is Judson Lea, Coo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revive Pathway's NPI active?
- Yes — Revive Pathway's NPI (1962117440) is active in the NPPES registry as of the last update on 2026-05-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.