Nicholas Anatoly Evans, PA-C
Individual provider Active NPI Physician Assistant · Perry, FL
NPI 1083386569 · NPPES record last updated Oct 2, 2021
Key facts
- NPI
- 1083386569
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9115061 (FL)
- Practice address
- 315 E Ash St
Perry, FL 32347-2029 - Phone
- (850) 584-3278
- NPI assigned
- Oct 2, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urgent Care Cure LLC
Practice addresses (Care Compare)
10870 US Hwy 1 N
Suite 104
Ponte Vedra, FL 32081-7800
10870 US Hwy 1 N
Unit 104
Ponte Vedra, FL 32081-7804
10870 US One N
Unit 104
Ponte Vedra, FL 32081-7804
Phone (904) 438-2720
3735 Longleaf Pine Pkwy
Unit 207
Saint John, FL 32259-7483
Phone (904) 438-2720
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211012000291 | FL | Practitioner - Physician Assistant | 8123426855 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9115061 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care Cure LLC | Current |
Accepting new patients | |
| Urgent Care Cure, LLC | Current |
Accepting new patients |
Locations
10870 US One N
Unit 104
Ponte Vedra Beach, FL 32081
Phone (904) 438-2720
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9115061 | FL | Yes |
Addresses
Primary practice location
315 E Ash St
Perry, FL 32347-2029
Mailing address
4000 Saint Johns Ave Apt 6201
Jacksonville, FL 32205-9487
Phone (571) 245-5358
Other providers in Perry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.