NPIMap

Individual provider Active NPI

Evan Matthew Tavakoli, M.D.

  • Orthopaedic Surgery Physician
  • Florence, OR
National Provider Identifier
1275894461
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD225448 Issued in OR
Practice address
530 9TH St
Florence, OR 97439-7388
Phone
(541) 997-7104
Fax
(541) 997-5975
NPI assigned
Jun 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 222577 ND
Orthopaedic Surgery Physician 207X00000X DR.0058700 CO
Orthopaedic Surgery Physician 207X00000X MD225448 OR Primary

Addresses

Primary practice location

530 9TH St
Florence, OR 97439-7388

Mailing address

75 Francis St
Boston, MA 02115-6106

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 724-4133

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, OR, MA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250624002946 ND Practitioner - Orthopedic Surgery 8729370861 Reassigns benefits to 1 organization
I20250708001248 OR Practitioner - Orthopedic Surgery 8729370861 Reassigns benefits to 2 organizations
I20260624003514 MA Practitioner - Orthopedic Surgery 8729370861

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Medical Branch at Galveston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 4587573001, 26 clinicians

Practice addresses (Care Compare)

530 9TH St
Florence, OR 97439-7388
Phone (541) 997-7104

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0058700COMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health CurrentSince Jun 9, 2025 Accepting new patients
Peacehealth CurrentSince Dec 1, 2025 Accepting new patients
Trinity Health Current Accepting new patients
Trinity Health CurrentSince Jun 9, 2025 Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

2305 37th Ave SW
Minot, ND 58701
Phone (701) 418-8550

101 3rd Ave SW
Minot, ND 58701
Phone (701) 857-5286

400 9th St
Florence, OR 97439
Phone (541) 997-8412

530 9th St
Florence, OR 97439
Phone (541) 997-7104

Interoperability endpoints

  • Direct secure messaging: etavakoli633802@christushealth.direct-ci.net
  • Direct secure messaging: etavakoli768759@direct.peacehealth.org

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 8

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1275894461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974397388",
            "telephone_number": "541-997-7104",
            "fax_number": "541-997-5975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-724-4133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVAKOLI",
        "first_name": "EVAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ND",
            "license": "222577",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "DR.0058700",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD225448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, OR

Sources for this page

Verify at the official NPI Registry.