Active NPI
Evan Johnson, D.P.T.
- Physical Therapist
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 016746
- Practice address
- 590 5TH Ave FL 5
New York, NY 10036-4702 - Phone
- (212) 305-4878
- Fax
- (646) 317-2902
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QAO673200 | NJ | |
| Physical Therapist | 225100000X | 016746 | NY | Primary |
Addresses
Primary practice location
590 5TH Ave FL 5
New York, NY 10036-4702
Mailing address
622 W 168TH St PH 11-102
New York, NY 10032-3720
Phone (212) 305-4878
Electronic endpoints 5
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | evj9001@direct.nyp.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 85.32
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016746 | NY | MD | Psychologist |
| 40QAO673200 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients |
Locations
710 W 168th St
Ste 425
New York, NY 10032
Phone (212) 305-1090
710 W 168th St
#516
New York, NY 10032
710 W 168th St
New York, NY 10032
Phone (212) 305-0217
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
622 W 168th St
Ph 11102
New York, NY 10032
Phone (212) 305-4878
710 W 168th St
Fl 5
New York, NY 10032
Phone (212) 305-1550
590 5th Ave
Fl 5
New York, NY 10036
Phone (212) 305-4878
Interoperability endpoints
- evj9001@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 2
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.
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- NPI 1699289488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1063424802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 W 168TH ST PH 11-102",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-4878",
"fax_number": "646-317-2902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 5TH AVE FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100364702",
"telephone_number": "212-305-4878",
"fax_number": "646-317-2902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "EVAN",
"name_prefix": "Dr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QAO673200",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "016746",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "590 5th Ave Fl 5",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100364702",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "590 5th Ave Fl 5",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100364702",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "590 5th Ave Fl 5",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100364702",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "590 5th Ave Fl 5",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100364702",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "evj9001@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "590 5th Ave Fl 5",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100364702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.