NPIMap

Individual provider Active NPI

Bayani V. Evangelista, M.D.

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
National Provider Identifier
1083664262
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A85985 Issued in CA
Practice address
39000 Bob Hope Dr
Eisenhower Imaging Center
Rancho Mirage, CA 92270-3221
Phone
(760) 340-3911
Fax
(760) 674-3852
NPI assigned
May 11, 2006
Last updated
May 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A85985 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr
Eisenhower Imaging Center
Rancho Mirage, CA 92270-3221

Mailing address

PO Box 910329
San Diego, CA 92191-0329
Phone (858) 564-1400

Other identifiers 2

IdentifierTypeStateIssuer
00A859850OtherCABLUE SHIELD OF CA
00A859850MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050706000254 CA Practitioner - Diagnostic Radiology 4082500137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Desert Radiology Medical Group IncGroup PAC ID 0749173789, 125 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 773-1251

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.08 of 100Reported as group
Quality
81.28
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A85985CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Desert Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Jun 1, 2005 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Jan 29, 2024 Accepting new patients
Eisenhower Medical Center Past Accepting new patients
Desert Ear, Nose & Throat Medical Group, Inc. Past Accepting new patients

Locations

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
Ste W301
Rancho Mirage, CA 92270
Phone (760) 340-4566

70390 Highway 111
Rancho Mirage, CA 92270

2510 Airpark Dr
Ste 301
Redding, CA 96001
Phone (530) 242-3500

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1083664262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910329",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921910329",
            "telephone_number": "858-564-1400",
            "fax_number": "858-564-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "EISENHOWER IMAGING CENTER",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-340-3911",
            "fax_number": "760-674-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "BAYANI",
        "middle_name": "V.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A85985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00A859850",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A859850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.