Individual provider Active NPI

Nathaniel Rutherford Evans III, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Philadelphia, PA
National Provider Identifier
1285780239
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD438594 Issued in PA
Practice address
834 Walnut St
Suite 650
Philadelphia, PA 19107-5109
Phone
(215) 955-6996
Fax
(215) 923-6003
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 231078 MA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD438594 PA Primary

Addresses

Primary practice location

834 Walnut St
Suite 650
Philadelphia, PA 19107-5109

Mailing address

834 Walnut St
Suite 650
Philadelphia, PA 19107-5109

Other identifiers 2

IdentifierTypeStateIssuer
102426904MedicaidPA
0222682MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100331000084 PA Practitioner - Thoracic SurgeryPractitioner - General Surgery 0345376174 Reassigns benefits to 2 organizations
I20220119001104 NJ Practitioner - Thoracic Surgery 0345376174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University Physicians of New Jersey PCGroup PAC ID 9931325131, 117 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

1 A Regulus Dr
Turnersville, NJ 08012-2427
Phone (856) 256-7514

1300 Wolf St
Philadelphia, PA 19148-2912
Phone (215) 952-1428

443 Laurel Oak Rd
Voorhees, NJ 08043-4419

5401 Old York Rd
Philadelphia, PA 19141-3045

5501 Old York Rd
Phila, PA 19141-3018

5501 Old York Rd Levy 2
Einstein Pediatrics Associates
Philadelphia, PA 19141-3018
Phone (215) 456-6786

5501 Old York Rd WCB 4TH FLR
Einstein CT Surgery Assoc
Philadelphia, PA 19141-3018
Phone (215) 456-8270

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231078MAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Current Accepting new patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince Feb 22, 2022 Accepting new patients
Kennedy Medical Group Practice P.C. CurrentSince Nov 18, 2021 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 1, 2022 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 1, 2022 Accepting new patients
Jefferson University Physicians CurrentSince Feb 1, 2010 Accepting new patients
Kennedy Medical Group Practice, P.C. Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Nov 18, 2021 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

1 Regulus Dr
#A
Turnersville, NJ 08012
Phone (609) 589-7770

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

1101 Chestnut St
#11
Philadelphia, PA 19107

1300 Wolf St
Philadelphia, PA 19148
Phone (215) 952-1428

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

834 Walnut St
Ste 650
Philadelphia, PA 19107
Phone (215) 928-7000

Organizations & group practices 10

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 3

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1285780239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 WALNUT ST",
            "address_2": "SUITE 650",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 WALNUT ST",
            "address_2": "SUITE 650",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-955-6996",
            "fax_number": "215-923-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "NATHANIEL",
        "middle_name": "RUTHERFORD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "231078",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD438594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102426904",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0222682",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.