Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Fred Revoredo, MD

Individual provider Emergency Medicine Physician · NPI 1669588422

Dr. Fred Revoredo, MD is a Family Practice in Paterson, New Jersey. Graduated from George Washington University School of Medicine in 1995, 31 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
31
Trained at
George Washington University School of Medicine
Licensed in
NJ
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

425 15th Ave
Paterson, NJ 07504-1811
Phone: (973) 345-4155
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25MA07147400 (NJ)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 25MA07147400 (NJ)

Record details

NPI number1669588422
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 22, 2006
Last updated in NPPESJuly 29, 2024
Certification dateJuly 29, 2024
Mailing address425 15th Avenue, Paterson, NJ 07504-1811

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolGEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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