Individual provider Active NPI

John Robert Evans, MD

  • Gastroenterology Physician
  • San Bernardino, CA
National Provider Identifier
1245253582
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G50624 Issued in CA
Practice address
355 E 21St Street Suite
San Bernardino, CA 92404
Phone
(909) 886-2609
Fax
(909) 886-0328
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G50624 CA Primary

Addresses

Primary practice location

355 E 21St Street Suite
San Bernardino, CA 92404

Mailing address

355 E 21St Street Suite H
San Bernardino, CA 92404
Phone (909) 886-2609

Other identifiers 1

IdentifierTypeStateIssuer
00G506240MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050201001020 CA Practitioner - Gastroenterology 7214988898 Reassigns benefits to 2 organizations
Practice locations: Huntington Beach, CA; San Bernardino, CA

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Jefferson Medical College of Thomas Jefferson University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

212 Summit Ave
Redlands, CA 92373-6852
Phone (909) 709-5099

355 E 21St St
Suite H
San Bernardino, CA 92404-4851
Phone (909) 793-5511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy40
Upper gastrointestinal (GI) endoscopy for acid reflux59
Removal of skin lesions2319

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50624CAMDPharmacist
G50624CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gtubes Inc Gastroenterology CurrentSince Jul 2, 2024 Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
John R Evans MD Gastroenterology Past Accepting new patients
Dignity Health Past Accepting new patients
Redlands Community Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1245253582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E 21ST STREET SUITE H",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92404",
            "telephone_number": "909-886-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E 21ST STREET SUITE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92404",
            "telephone_number": "909-886-2609",
            "fax_number": "909-886-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G50624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G506240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.