Evan Ashley Gillo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005861 Issued in MI

Practice address

955 S Bailey Ave
South Haven, MI 49090-9701

Phone

(269) 637-5271

Fax

(269) 639-2919

NPI assigned

Sep 17, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph Mercy HospitalGroup PAC ID 3779489281, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Joseph Mercy Hospital

  • Otolaryngology Physician
  • Ypsilanti, MI
  • NPI 1659499705
  Medicare reassignment Care Compare group
• Chelsea Community Hospital

  • Psychiatry Physician
  • Chelsea, MI
  • NPI 1912947409
  Medicare reassignment NPD
• Saint Joseph Mercy Livingston Hospital

  • Emergency Medicine Physician
  • Brighton, MI
  • NPI 1285753236
  Medicare reassignment
• Chelsea Community Hospital

  • Urgent Care Clinic/Center
  • Chelsea, MI
  • NPI 1033778733
  NPD
• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  NPD
• St Joseph Mercy Hospital

  • Internal Medicine Physician
  • Ypsilanti, MI
  • NPI 1649399197

  Physician Assistant

  NPD
• St Joseph Mercy Hospital

  • Cardiac Rehabilitation Clinic/Center
  • Ypsilanti, MI
  • NPI 1902359094
  NPD
• St Joseph Mercy Hospital

  • Certified Registered Nurse Anesthetist
  • Howell, MI
  • NPI 1265497705
  NPD (past)
• St Joseph Mercy Hospital

  • Internal Medicine Physician
  • Ypsilanti, MI
  • NPI 1548388606
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1013225549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909701",
            "telephone_number": "269-637-5271",
            "fax_number": "269-639-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909701",
            "telephone_number": "269-637-5271",
            "fax_number": "269-639-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLO",
        "first_name": "EVAN",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Flessner, RN
• Lisa Ellen Follman
• Michele Patricia Fontaine, RN
• Paul Frederick
• Friends Who Care-South Haven,LLC
• William Dean Gilmer, CRNA
• Rhonda Jo Gola, FNP
• Graceway South Haven, LLC
• Great Lakes Eye Care, P.C.
• Carly Anastacia Greenhoe, PHARMD

• Physician Assistant in South Haven, MI
• Providers in South Haven, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.