Edmund S Evangelista, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A64745 Issued in CA

Practice address

26401 Crown Valley Pkwy
Suite 101
Mission Viejo, CA 92691-6302

Phone

(949) 348-4000

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and RehabilitationAlso: Pain Management

Education

Tufts University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Xcell Sports and Regenerative Medicine IncGroup PAC ID 8426326083, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: edmund.evangelista@sdomg-ca.direct.office.nextgen.com

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.

• Xcell Sports and Regenerative Medicine Inc

  dba San Diego Orthobiologics Medical Group

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Carlsbad, CA
  • NPI 1174063218
  Medicare reassignment Care Compare group
• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144287434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916302",
            "telephone_number": "949-348-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916302",
            "telephone_number": "949-348-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "EDMUND",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A64745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Essex, CCC-SLP
• Manijeh Esteghlalian
• Evelyn Estrada
• Mayra Jane Estrada, MA.,
• Veronica Estrada, FNP
• Sherri Evans
• Everwell Recovery LLC
• Eyedeology Optometry of Mission Viejo (Eyedeology Optometry)
• Andrew Theodore Ezpeleta, ACSW
• F Awadalla MD PC (Skincredible Dermatology & Surgery)

• Physical Medicine & Rehabilitation Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.