Individual provider Active NPI

Timothy Kent Evje, PA-C

  • Physician Assistant
  • Indio, CA
National Provider Identifier
1023411949
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52009 Issued in CA
Practice address
47111 Monroe St
Indio, CA 92201-6739
Phone
(760) 775-8111
NPI assigned
Oct 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52009 CA Primary

Addresses

Primary practice location

47111 Monroe St
Indio, CA 92201-6739

Mailing address

47111 Monroe St
Indio, CA 92201-6739
Phone (760) 775-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150113000076 CA Practitioner - Physician Assistant 8224352612 Reassigns benefits to 4 organizations
I20240712002155 NM Practitioner - Physician Assistant 8224352612 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
52009CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jul 1, 2024 Accepting new patients
Cep America - California CurrentSince Oct 1, 2016 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

7400 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 596-2400

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777

Interoperability endpoints

  • Direct secure messaging: tevje252042@direct.phs.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1023411949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47111 MONROE ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016739",
            "telephone_number": "760-775-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47111 MONROE ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016739",
            "telephone_number": "760-775-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVJE",
        "first_name": "TIMOTHY",
        "middle_name": "KENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-06",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.