Individual provider Active NPI

Oksana Evans, PA

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1225579618
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1639 Atlantic Blvd
Jacksonville, FL 32207-3346
Phone
(904) 224-1171
NPI assigned
Mar 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1639 Atlantic Blvd
Jacksonville, FL 32207-3346

Mailing address

151 Southhall LN Ste 300
Maitland, FL 32751-7172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201106001085 MN Practitioner - Physician Assistant 5496022790
I20220406001215 FL Practitioner - Physician Assistant 5496022790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12525 Philips Hwy
Suite 101
Jacksonville, FL 32256-3740
Phone (904) 400-6565

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

71 Doctors Village Dr
Suite 304
Saint Johns, FL 32259-2406
Phone (904) 547-2580

7855 Argyle Forest Blvd
Suite 701
Jacksonville, FL 32244-7705
Phone (904) 483-2277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13436MNMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 1, 2022 Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients

Locations

1639 Atlantic Blvd
Ste 100
Jacksonville, FL 32207

7855 Argyle Forest Blvd
Ste 701
Jacksonville, FL 32244
Phone (904) 483-2277

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1893 Kingsley Ave
Ste B
Orange Park, FL 32073
Phone (904) 272-6955

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

71 Doctors Village Dr
Ste 304
Saint Johns, FL 32259
Phone (904) 547-2580

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1225579618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073346",
            "telephone_number": "904-224-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "OKSANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2023-01-24",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.