Individual provider Active NPI

Evan James Gaudette, PA-C

  • General Practice Physician
  • Bridgeport, CT
National Provider Identifier
1275488108
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
7631 Issued in CT
Practice address
754 Clinton Ave
Bridgeport, CT 06604-2369
Phone
(207) 951-3929
NPI assigned
Mar 4, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 7631 CT Primary

Addresses

Primary practice location

754 Clinton Ave
Bridgeport, CT 06604-2369

Mailing address

327 Riverside Ave
Westport, CT 06880-4821

Other practice location 1

327 Riverside Ave
Westport, CT 06880-4821
Phone (203) 221-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1275488108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 RIVERSIDE AVE",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 CLINTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042369",
            "telephone_number": "207-951-3929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Westport",
            "state": "CT",
            "postal_code": "068804821",
            "country_code": "US",
            "telephone_number": "203-221-3030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUDETTE",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "7631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.