Stephanie Evanson, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01081251A Issued in IN

Practice address

10020 Donald S Powers Dr Ste 2a
Munster, IN 46321-4054

Phone

(219) 703-2427

Fax

(219) 703-6961

NPI assigned

Apr 13, 2010

Last updated

Dec 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Obstetrics/Gynecology

Education

Indiana University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

219 Health Network IncGroup PAC ID 0547521452, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125
• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
• Powers Health Rehabilitation Center Inpatient rehabilitation facility, Crown Point, IN, CCN 153045

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• 219 Health Network Inc

  • Family Medicine Physician
  • East Chicago, IN
  • NPI 1093213506

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Community Care Network Inc

  dba Powers Health Medical Group

  • Family Medicine Physician
  • Saint John, IN
  • NPI 1457610487

  Obstetrics & Gynecology

  Medicare reassignment NPD
• 219 Health Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Munster, IN
  • NPI 1407539471

  Obstetrics & Gynecology

  NPD
• 219 Health Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Munster, IN
  • NPI 1417811738
  NPD

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

• Community Stroke and Rehabilitation Center Inc

  dba Powers Health Rehabilitation Center

  • Rehabilitation Hospital
  • Crown Point, IN
  • NPI 1801301437

  Inpatient rehabilitation facility

  Care Compare affiliation
• Munster Medical Research Foundation Inc

  dba Community Hospital

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  dba St Mary Wound Clinic

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1245556455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 DONALD S POWERS DR STE 2A",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214054",
            "telephone_number": "219-703-2427",
            "fax_number": "219-703-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANSON",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "62305",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01081251A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300019320",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102266823",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esteemed Therapeutic Associates, LLC
• Avram Estes, M.D.
• Hailey Corrinne Estes, PHARMD
• Ethos Dental Group L.L.C.
• Brian John Evanson, M.D.
• Brynalyn Evorik, LMT
• Extraordinary Rehab Services, LLC
• Erica L Faanes, MSOT
• Fairmeadows Pharmacy (Fairmeadows Pharmacy/HME)
• Fairmeadows Pharmacy Inc

• Obstetrics & Gynecology Physician in Munster, IN
• Providers in Munster, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.