Bernardo S. Evangelista, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

099944 Issued in NY

Practice address

244 Ontario St
Cohoes, NY 12047-2868

Phone

(518) 237-5656

NPI assigned

Jul 14, 2006

Last updated

Oct 6, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cohoes Physicians PC

  • Clinic/Center
  • Cohoes, NY
  • NPI 1447392949
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1104842921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 ONTARIO ST",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472868",
            "telephone_number": "518-237-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 ONTARIO ST",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472868",
            "telephone_number": "518-237-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "BERNARDO",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "099944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10000593",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Doesburg, M.S., L.M.H.C.
• Deena M Dominy, PT
• Chelsea Lyn Donnelly, PA-C
• Tara Mae Dutcher, DPT
• Empire NP Psychiatric Care, PLLC
• Jill Marie Facteau I, LPN
• Brittany Erin Fahd
• Deborah Fahrbach
• Laura Kathleen Fay, COTA
• Noah Felix

• Specialist in Cohoes, NY
• Providers in Cohoes, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.