NPIMap

Individual provider Active NPI

Rex D Evans, PA-C

  • Physician Assistant
  • Du Bois, PA
National Provider Identifier
1215927512
Registry record updated May 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055178 Issued in PA
Practice address
145 Hospital Ave
Suite 311
Du Bois, PA 15801-1462
Phone
(814) 375-3750
Fax
(814) 375-9624
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C5-0000358 DE
Physician Assistant 363A00000X C5-0000358 DE
Physician Assistant 363A00000X MA055178 PA Primary

Addresses

Primary practice location

145 Hospital Ave
Suite 311
Du Bois, PA 15801-1462

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-3750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111221000515 PA Practitioner - Physician Assistant 9537352265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearfield-Jefferson Primary Care Associates PCGroup PAC ID 6002064433, 73 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1036 Park Ave Ext
Clearfield, PA 16830-4028
Phone (814) 503-8070

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

33 Beaver Dr
Suite 1
Du Bois, PA 15801-2434
Phone (814) 503-8070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Physician Assistant Past Accepting new patients
Modern Maturity Center PastSince Jan 15, 2023 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Dubois Regional Medical Group, PC Physician Assistant Past Accepting new patients

Organizations & group practices 5

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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338163200000",
    "number": "1215927512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-3750",
            "fax_number": "814-375-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE",
            "address_2": "SUITE 311",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011462",
            "telephone_number": "814-375-3750",
            "fax_number": "814-375-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "REX",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2012-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C5-0000358",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000358",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.