Active NPI
Blake Alexander Evans
- Physical Medicine & Rehabilitation Physician
- Albany, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 64405
- Practice address
- 400 Hickory St NW
Albany, OR 97321-1700 - Phone
- (541) 812-5840
- NPI assigned
- Jun 23, 2022
- Last updated
- Aug 22, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 64405 | OR | Primary |
Addresses
Primary practice location
400 Hickory St NW
Albany, OR 97321-1700
Mailing address
PO Box 1188
Corvallis, OR 97339-1188
Other practice location 1
1046 6th Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bevans241569@samhealth.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 Hickory St NW
Suite 201
Albany, OR 97321-1700
Phone (541) 812-5840
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.37 of 100
- Quality
- 92.31
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 80.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64405 | OR | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany General Hospital | Current | Accepting new patients | |
| Albany General Hospital | Current | Accepting new patients | |
| Albany General Hospital | Current | Accepting new patients | |
| Corvallis Radiology PC | Past | Accepting new patients |
Locations
1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000
400 Hickory St NW
Ste 201
Albany, OR 97321
Phone (541) 812-5840
705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850
815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888
Organizations & group practices 4
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.
-
dba Samaritan Albany General Hospital
- General Acute Care Hospital
- Albany, OR
- NPI 1154372340
-
dba Samaritan InterCommunity Health Clinic - Albany
- Family Medicine Physician
- Albany, OR
- NPI 1306679816
-
dba Samaritan Kidney Specialists - Albany
- Nephrology Physician
- Albany, OR
- NPI 1700145786
-
- Diagnostic Radiology Physician
- Corvallis, OR
- NPI 1881651289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1285365734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1188",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HICKORY ST NW",
"city": "ALBANY",
"state": "OR",
"postal_code": "973211700",
"telephone_number": "541-812-5840"
}
],
"practiceLocations": [
{
"address_1": "1046 6th Ave SW",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "OR",
"postal_code": "973211916",
"country_code": "US",
"telephone_number": "541-812-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "BLAKE",
"middle_name": "ALEXANDER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-23",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OR",
"license": "64405",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bevans241569@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "400 Hickory St NW",
"city": "Albany",
"state": "OR",
"country_code": "US",
"postal_code": "973211700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Albany, OR
- Michael K Estes, O.D.
- Edwar Jose Fernando Estupinian
- Eudaemonia Behavioral Health LLC
- Hailey Amanda Eustice, MS, CCC-SLP
- Sara Evanko, PHARMD
- George Pete Evans
- Joshua John Exton, B.S.
- Eyecare Associates PC
- F & F Associates - Albany/Salem, Inc (Marquis Home Health - Albany)
- F & G Investments, LLC (Pediatric Dental Associates)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.