Individual provider Active NPI

Eileen S Evangelista, NP

  • Nurse Practitioner
  • Newark, DE
National Provider Identifier
1194155036
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
L1-0028628 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Room 1049E
Newark, DE 19718-2200
Phone
(302) 733-1487
NPI assigned
Nov 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X L1-0028628 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Room 1049E
Newark, DE 19718-2200

Mailing address

PO Box 30170
Wilmington, DE 19805-7170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140130000846 DE Practitioner - Nurse Practitioner 5496984072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-5982

501 W 14TH St
Wilmington, DE 19801-1013
Phone (302) 623-3017

774 Christiana Rd
Suite 201
Newark, DE 19713-4221
Phone (302) 623-3017

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L1-0028628DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Dec 2, 2013 Accepting new patients
Christiana Care Health Services Inc Nurse Practitioner CurrentSince Dec 2, 2013 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Rm 1049E
Newark, DE 19718
Phone (302) 733-1487

4755 Ogletownstanton Rd
Newark, DE 19718
Phone (302) 733-6510

774 Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 623-3017

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Organizations & group practices 2

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": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1194155036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30170",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198057170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "ROOM 1049E",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "EILEEN",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-13",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "L1-0028628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.