NPIMap

Individual provider Active NPI

David L Evans, MD

  • Diagnostic Radiology Physician
  • Fairbanks, AK
National Provider Identifier
1306010962
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
6916 Issued in AK
Practice address
1650 Cowles St
Fairbanks, AK 99701-5999
Phone
(907) 458-5660
NPI assigned
Apr 15, 2008
Last updated
Feb 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 6916 AK Primary

Addresses

Primary practice location

1650 Cowles St
Fairbanks, AK 99701-5999

Mailing address

PO Box 73370
Fairbanks, AK 99707-3370
Phone (907) 452-6464

Other identifiers 1

IdentifierTypeStateIssuer
MD1539MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20100920001167 AK Practitioner - Diagnostic Radiology 8123185493 Reassigns benefits to 4 organizations
I20161003001792 TX Practitioner - Diagnostic Radiology 8123185493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Oklahoma College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Consultants a Professional CorpGroup PAC ID 0749173029, 11 clinicians
Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians
Fairbanks Ultrasound LLC.Group PAC ID 3577745264, 8 clinicians

Practice addresses (Care Compare)

1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 456-2784

1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682

3419 Airport Way
Suite D
Fairbanks, AK 99709-4765
Phone (907) 374-4644

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.28 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
89.24

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6916AKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Peninsula Hospital, Inc CurrentSince Aug 24, 2022 Accepting new patients
Radiology Consultants a Professional Corp Diagnostic Radiology CurrentSince Aug 2, 2010 Accepting new patients
South Peninsula Hospital, Inc CurrentSince Aug 1, 2022 Accepting new patients
Fairbanks Ultrasound, LLC. CurrentSince Aug 1, 2024 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Feb 7, 2023 Accepting new patients
South Peninsula Hospital, Inc. Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Tanana Chiefs Conference CurrentSince Aug 7, 2016 Accepting new patients
Tanana Chiefs Conference CurrentSince Aug 7, 2016 Accepting new patients

Locations

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682

3419 Airport Way
Ste D
Fairbanks, AK 99709
Phone (907) 374-4644

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sphosp-0c203fcf

Organizations & group practices 8

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1306010962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73370",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997073370",
            "telephone_number": "907-452-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015999",
            "telephone_number": "907-458-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "6916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1539",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.