Allan Evangelista, D.P.M., M.P.H.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

10442 Issued in WV

Practice address

110 New Stine Rd
Bakersfield, CA 93309-2605

Phone

(661) 832-1667

Fax

(661) 832-7145

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in WV, CA, TX3 enrollments

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 3

Specialty

Podiatry

Education

Temple University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHHS PHS Naihs Chinle Comprehensive Health Care FacilityGroup PAC ID 9436062585, 160 clinicians

Kayenta Alternative Rural HospitalGroup PAC ID 3678558129, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kayenta Alternative Rural Hospital Hospital, Kayenta, AZ, CCN 030195

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: allanevangelista@wdsmdinc.allscriptsdirect.net
• Direct secure messaging: allan.evangelista.p1@direct.lakeside.nextgenshare.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.

• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment Care Compare group NPD
• Kayenta Alternative Rural Hospital

  • General Acute Care Hospital
  • Kayenta, AZ
  • NPI 1174692529

  TX

  Medicare reassignment Care Compare group NPD
• J&P Spine Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fresno, CA
  • NPI 1164980744
  Medicare reassignment NPD
• Mariam Amiri

  • Podiatrist
  • Apple Valley, CA
  • NPI 1235140336
  Medicare reassignment NPD
• Mountaineer Orthopedic Specialists, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Morgantown, WV
  • NPI 1568522258
  Medicare reassignment NPD
• J&P Spine Center Inc

  • Interventional Pain Medicine Physician
  • Madera, CA
  • NPI 1043104961
  NPD
• Mariam Amiri

  • Podiatrist
  • Loma Linda, CA
  • NPI 1497769731
  NPD
• DHHS PHS Naihs Chinle Comprehensive

  • Ambulatory Surgical Clinic/Center
  • Chinle, AZ
  • NPI 1922253129
  NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Tsaile, AZ
  • NPI 1538185715
  NPD
• Kayenta Alternative Rural Hospital

  • General Acute Care Hospital
  • Tonalea, AZ
  • NPI 1740359108
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1154480887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 NEW STINE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933092605",
            "telephone_number": "661-832-1667",
            "fax_number": "208-719-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NEW STINE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933092605",
            "telephone_number": "661-832-1667",
            "fax_number": "661-832-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5423",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4022",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003534",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC005582",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WV",
            "license": "10442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2834099",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "2018774",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MA GROUP",
            "identifier": "1007775620010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS GROUP FOR PODIATRY",
            "identifier": "2022587",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "412213",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC RR",
            "identifier": "P00658026",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020943590001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "812105",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelyn Dianne Eterno, MSW ASW
• Soheil Etesham, MD
• Victor George Ettinger, M.D.
• Prince Even Arden Eugenio, RN, CNOR, RNFA
• Ev Contacts
• Brande Elexis Evans, PSYD
• Gary Walter Evans, DC
• James Evans
• Michael Lynn Evans, ASW
• Walter Jackson Evans II

• Foot & Ankle Surgery Podiatrist in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Foot & Ankle Surgery Podiatrist 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.