NPIMap

Individual provider Active NPI

Christopher M Evanson, M.D.

  • Surgery Physician
  • Carmel, IN
National Provider Identifier
1124058045
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01055850A Issued in IN
Practice address
13430 N Meridian St
Suite 275
Carmel, IN 46032-1405
Phone
(317) 582-8810
Fax
(317) 582-8863
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01055850A IN Primary

Addresses

Primary practice location

13430 N Meridian St
Suite 275
Carmel, IN 46032-1405

Mailing address

13430 N Meridian St
Suite 275
Carmel, IN 46032-1405
Phone (317) 582-8810

Other identifiers 2

IdentifierTypeStateIssuer
P00787053OtherINRAILROAD MEDICARE
200384180MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christopher.evanson.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050825001019 IN Practitioner - General Surgery 0345271607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

13430 N Meridian St
Suite 275
Carmel, IN 46032-1484
Phone (317) 582-8815

Hospital & facility affiliations

  • Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157
  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01055850AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Surgical Sciences & Trauma, Inc Surgery Past Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients
Indiana University Health North Hospital, Inc Surgery Past Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: christopher.evanson.1@7598.direct.athenahealth.com

Organizations & group practices 9

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.

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1124058045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13430 N MERIDIAN ST",
            "address_2": "SUITE 275",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321405",
            "telephone_number": "317-582-8810",
            "fax_number": "317-582-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13430 N MERIDIAN ST",
            "address_2": "SUITE 275",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321405",
            "telephone_number": "317-582-8810",
            "fax_number": "317-582-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01055850A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00787053",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200384180",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopher.evanson.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "13430 N Meridian St",
            "address_2": "Suite 275",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460321405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.