Individual provider Active NPI

Evans Crevecoeur, MD

  • Anesthesiology Physician
  • Jamaica, NY
National Provider Identifier
1053351973
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
177953 Issued in NY
Practice address
8900 Van Wyck Expy
Jamaica Anesthesia Associates PC
Jamaica, NY 11418-2897
Phone
(718) 206-6088
Fax
(718) 206-8087
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 177953 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Jamaica Anesthesia Associates PC
Jamaica, NY 11418-2897

Mailing address

PO Box 30037
Elmont, NY 11003-0037
Phone (718) 433-0044

Other identifiers 1

IdentifierTypeStateIssuer
01424253MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040712001103 NY Practitioner - Anesthesiology 6305824707 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York Downstate Medical Center, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1975 Linden Blvd
Suite 107
Elmont, NY 11003-4004
Phone (718) 433-0044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198461NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Anesthesiologist, PC Anesthesiology CurrentSince Oct 25, 2000 Accepting new patients
Brooklyn Anesthesia Group, PC Anesthesiology CurrentSince Dec 1, 2011 Accepting new patients
Choices Women'S Medical Center, Inc. CurrentSince Sep 5, 2018 Accepting new patients
Comprehensive Medical Care, PC CurrentSince Jul 17, 2019 Accepting new patients
Trenton Chiropractic Clinic LTD Past Accepting new patients
Omnicare Anesthesia PastSince Jul 19, 2004 Accepting new patients

Locations

55 Greene Ave
#L
Brooklyn, NY 11238
Phone (718) 369-3080

1975 Linden Blvd
Ste 107
Elmont, NY 11003
Phone (718) 354-6810

19616 Hillside Ave
Hollis, NY 11423
Phone (718) 217-6806

14732 Jamaica Ave
Jamaica, NY 11435
Phone (718) 206-2002

1841 Broadway
Rm 1011
New York, NY 10023
Phone (212) 333-5000

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

222 Mamaroneck Ave
White Plains, NY 10605
Phone (914) 401-4282

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFCHAA/Endpoint/CFCHAA

Organizations & group practices 6

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1053351973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30037",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110030037",
            "telephone_number": "718-433-0044",
            "fax_number": "646-680-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "address_2": "JAMAICA ANESTHESIA ASSOCIATES PC",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6088",
            "fax_number": "718-206-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREVECOEUR",
        "first_name": "EVANS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "177953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01424253",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.