Individual provider Active NPI

Evan Kohler, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Grand Blanc, MI
National Provider Identifier
1043879893
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
4301507685 Issued in MI
Practice address
861 Health Park Blvd
Grand Blanc, MI 48439-7383
Phone
(810) 953-0500
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 4301507685 MI Primary

Addresses

Primary practice location

861 Health Park Blvd
Grand Blanc, MI 48439-7383

Mailing address

861 Health Park Blvd
Grand Blanc, MI 48439-7383
Phone (810) 953-0500

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923004170 MI Practitioner - Orthopedic Surgery 3476887886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Western Michigan Un Homer Stryker School of Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians
Greater Flint Sports Medicine Center PCGroup PAC ID 2264332097, 11 clinicians

Practice addresses (Care Compare)

44003 Partridge Creek Blvd
Clinton TWP, MI 48038-0002
Phone (342) 627-3267

861 Health Park Blvd
Grand Blanc, MI 48439-7383
Phone (810) 953-0500

Hospital & facility affiliations

  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207
  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301507685MIMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Flint Sports Medicine Center PC Orthopaedic Surgery CurrentSince Sep 1, 2025 Accepting new patients

Locations

6400 Waldon Center Dr
Clarkston, MI 48346
Phone (248) 265-3001

861 Health Park Blvd
Grand Blanc, MI 48439
Phone (810) 953-0095

Interoperability endpoints

  • Direct secure messaging: evankohler@gmoortho.directglo.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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1043879893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 HEALTH PARK BLVD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397383",
            "telephone_number": "810-953-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 HEALTH PARK BLVD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397383",
            "telephone_number": "810-953-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MI",
            "license": "4301507685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.