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Individual provider Active NPI

Eugene Evra, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Maryland Heights, MO
National Provider Identifier
1336367226
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2008009812 Issued in MO
Practice address
11365 Dorsett Rd.
Maryland Heights, MO 63043
Phone
(314) 872-6430
Fax
(314) 872-6500
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X BB4745785 MO
Physical Medicine & Rehabilitation Physician 208100000X 2008009812 MO Primary

Addresses

Primary practice location

11365 Dorsett Rd.
Maryland Heights, MO 63043

Mailing address

11365 Dorsett Rd.
Maryland Heights, MO 63043
Phone (314) 872-6430

Other identifiers 1

IdentifierTypeStateIssuer
1336367226MedicaidMO

Other names 1

  • Yevgeniy Yevrayev Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130912000127 MO Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 7416191580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14561 N Outer 40 Rd
Chesterfield, MO 63017-5703
Phone (314) 881-4000

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
  • SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031
  • Mercy Rehabilitation Hospital St Louis Inpatient rehabilitation facility, Chesterfield, MO, CCN 263029

Merit-based Incentive Payment System (MIPS)

Final score
48.78 of 100Reported as individual
Quality
58.12
Improvement activities
0
Cost
68.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BB4745785MOMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients
SSM Select Rehab St. Louis, LLC Past Accepting new patients
Ranken-Jordan Home for Convalescent Crippled Children Past Accepting new patients
Mercy Rehabilitation Hospital - St Louis, LLC Past Accepting new patients

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1336367226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11365 DORSETT RD.",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "63043",
            "telephone_number": "314-872-6430",
            "fax_number": "314-872-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11365 DORSETT RD.",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "63043",
            "telephone_number": "314-872-6430",
            "fax_number": "314-872-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVRA",
        "first_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "BB4745785",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2008009812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336367226",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YEVGENIY",
            "last_name": "YEVRAYEV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maryland Heights, MO

Sources for this page

Verify at the official NPI Registry.