NPIMap

Individual provider Active NPI

George V Evanoff, M.D.

  • Nephrology Physician
  • Bremerton, WA
National Provider Identifier
1043206972
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00031897 Issued in WA
Practice address
2771 Hemlock St
Suite 201
Bremerton, WA 98310-2689
Phone
(360) 377-7634
Fax
(360) 479-6157
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD00031897 WA Primary

Addresses

Primary practice location

2771 Hemlock St
Suite 201
Bremerton, WA 98310-2689

Mailing address

2771 Hemlock St
Suite 201
Bremerton, WA 98310-2689
Phone (360) 377-7634

Other identifiers 2

IdentifierTypeStateIssuer
1088566MedicaidWA
1043206972OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080111000026 WA Practitioner - Nephrology 0143322651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Louisiana State University School of Medicine in New Orleans, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Kitsap County PLLCGroup PAC ID 1850393554, 3 clinicians

Practice addresses (Care Compare)

2771 Hemlock St
Suite 201
Bremerton, WA 98310-2689
Phone (360) 377-7634

Hospital & facility affiliations

  • Puget Sound Kidney Center-Port Orchard Dialysis facility, Port Orchard, WA, CCN 502532
  • Puget Sound Kidney Center-Bremerton Dialysis facility, Bremerton, WA, CCN 502502
  • NKC Port Angeles Kidney Center Dialysis facility, Port Angeles, WA, CCN 502510
  • Puget Sound Kidney Center-Port Townsend Dialysis facility, Port Townsend, WA, CCN 502565
  • Puget Sound Kidney Center-Poulsbo Dialysis facility, Poulsbo, WA, CCN 502549
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Merit-based Incentive Payment System (MIPS)

Final score
92.44 of 100Reported as individual
Quality
86.35
Promoting interoperability
87
Improvement activities
40
Cost
78.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00031897WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Kitsap County PLLC Nephrology CurrentSince Mar 1, 2008 Accepting new patients

Locations

2771 Hemlock St
Ste 201
Bremerton, WA 98310
Phone (360) 377-7634

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30201/brand/1/csg/1/fhir/r4
  • Direct secure messaging: george.evanoff.1@30201.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1043206972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 HEMLOCK ST",
            "address_2": "SUITE 201",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102689",
            "telephone_number": "360-377-7634",
            "fax_number": "360-479-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 HEMLOCK ST",
            "address_2": "SUITE 201",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102689",
            "telephone_number": "360-377-7634",
            "fax_number": "360-479-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANOFF",
        "first_name": "GEORGE",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00031897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1088566",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043206972",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.