Individual provider Active NPI

Evan Charles Seamons, MD

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1154950335
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.146795 Issued in OH
Practice address
2213 Cherry St
Toledo, OH 43608-2603
Phone
(419) 251-4724
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 35.146795 OH Primary

Addresses

Primary practice location

2213 Cherry St
Toledo, OH 43608-2603

Mailing address

2213 Cherry St
Toledo, OH 43608-2603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230109001867 OH Practitioner - Emergency Medicine 2062834898 Reassigns benefits to 2 organizations
I20240927001956 ID Practitioner - Emergency Medicine 2062834898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone (208) 814-1000

Hospital & facility affiliations

  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • Mercy Health - Tiffin Hospital Hospital, Tiffin, OH, CCN 360089

Merit-based Incentive Payment System (MIPS)

Final score
85.09 of 100Reported as group
Quality
77.1
Promoting interoperability
100
Improvement activities
40
Cost
73.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.146795OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Emergency Care Services, Inc. Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
St Luke'S Clinic LLC CurrentSince Jun 21, 2024 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Jul 20, 2023 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

Organizations & group practices 3

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 2

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": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1154950335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAMONS",
        "first_name": "EVAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.146795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.