Individual provider Active NPI

Robin D Evans, M.D.

  • Dermatology Physician
  • Stamford, CT
National Provider Identifier
1154495950
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
030597 Issued in CT
Practice address
1275 Summer St Ste 101
Stamford, CT 06905-5315
Phone
(203) 323-5660
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 030597 CT Primary
Dermatology Physician 207N00000X 1821531 NY

Addresses

Primary practice location

1275 Summer St Ste 101
Stamford, CT 06905-5315

Mailing address

1275 Summer St Ste 101
Stamford, CT 06905-5315
Phone (203) 323-5660

Other identifiers 1

IdentifierTypeStateIssuer
1992879795OtherCTMEDICARE GROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20050527000448 CT Practitioner - Dermatology 0840230462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Albert Einstein College of Medicine of Yeshiva University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1275 Summer St
Stamford, CT 06905-5315
Phone (203) 323-5660

Hospital & facility affiliations

  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision76
Removal of skin lesions232
Removal or shaving of skin growth1-10
Skin biopsy343

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030597CTMDDermatology Physician
1821531NYMDSpeech/Language/Hearing Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Connecticut Dermatology, P.C. Dermatology CurrentSince Sep 15, 1995 Accepting new patients

Locations

1275 Summer St
Ste 1
Stamford, CT 06905

1275 Summer St
Ste 101
Stamford, CT 06905
Phone (203) 323-5660

Organizations & group practices 1

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 1

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1154495950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST STE 101",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055315",
            "telephone_number": "203-323-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST STE 101",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055315",
            "telephone_number": "203-323-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ROBIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "030597",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "1821531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NPI",
            "identifier": "1992879795",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.