Individual provider Active NPI

Jason Anthony Evans, DPM

  • Podiatrist
  • Fort Lauderdale, FL
National Provider Identifier
1093704306
Registry record updated May 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO2835 Issued in FL
Practice address
2800 E Commercial Blvd
Suite 207
Fort Lauderdale, FL 33308-4229
Phone
(954) 776-5700
Fax
(954) 776-5701
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO2835 FL Primary

Addresses

Primary practice location

2800 E Commercial Blvd
Suite 207
Fort Lauderdale, FL 33308-4229

Mailing address

2800 E Commercial Blvd
Suite 207
Fort Lauderdale, FL 33308-4229
Phone (954) 776-5700

Other identifiers 1

IdentifierTypeStateIssuer
340316500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070221000462 FL Practitioner - Podiatry 2769584739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2800 E Commercial Blvd
Suite 207
Fort Lauderdale, FL 33308-4228
Phone (954) 776-5700

51 W Sample Rd
Pompano Beach, FL 33064-3542
Phone (954) 776-5700

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue16
Removal of nail tissue93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO2835FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jason Evans PA Podiatrist CurrentSince Nov 1, 2013 Accepting new patients
Mark E Pomper MD PA Past Accepting new patients
Phillip D.Decubellis PA Past Accepting new patients

Locations

51 W Sample Rd
Deerfield Beach, FL 33064
Phone (954) 942-0941

2828 E Commercial Blvd
Ft Lauderdale, FL 33308
Phone (954) 351-0009

2800 E Commercial Blvd
Ste 207
Ft Lauderdale, FL 33308
Phone (954) 536-3992

4750 N Federal Hwy
Ste 202
Ft Lauderdale, FL 33308
Phone (954) 449-6002

Organizations & group practices 3

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463788800000",
    "number": "1093704306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E COMMERCIAL BLVD",
            "address_2": "SUITE 207",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084229",
            "telephone_number": "954-776-5700",
            "fax_number": "954-776-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E COMMERCIAL BLVD",
            "address_2": "SUITE 207",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084229",
            "telephone_number": "954-776-5700",
            "fax_number": "954-776-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JASON",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2016-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340316500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.