Edil Evangelista, MSN RN PHN FNPC CCRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95012122 Issued in CA

Practice address

425 Diamond Dr Ste 105
Lake Elsinore, CA 92530-4495

Phone

(951) 674-8779

NPI assigned

Aug 28, 2019

Last updated

Oct 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eevangelista183370@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Total Care Family Medical Center of Lake Elsinore, Inc.

  • Family Medicine Physician
  • Lake Elsinore, CA
  • NPI 1992950703
  NPD
• Ernst Schwarz MD a Professional Medical Corporation

  • Cardiovascular Disease Physician
  • Beverly Hills, CA
  • NPI 1174967137
  NPD (past)

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1184272759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27649 PEPPERGRASS CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622806",
            "telephone_number": "714-345-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DIAMOND DR STE 105",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304495",
            "telephone_number": "951-674-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "EDIL",
        "credential": "MSN RN PHN FNPC CCRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.totalcarefamily.com/contact-lake-elsinore",
            "affiliation": "N",
            "address_1": "425 Diamond Dr Ste 105",
            "city": "Lake Elsinore",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925304495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Venus Esquivel, MD
• Alidiuska Estopinan Marzo
• Eileen Estrada, LVN
• Elizabeth Ivonne Estrada, APCC
• Lysette Nana Etti
• Donna Evelyn, PH.D.
• Ever Ready Home Care Service LLC
• Everlast Assisted Living LLC
• Everlasting Assisted Living
• Katherine Rose Fairweather

• Family Nurse Practitioner in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.