Active NPI
Frank Evangelista
- Forensic Pathology Physician
- Farmington, CT
National Provider Identifier
1417543240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Pathology Physician
- License
- 42830
- Practice address
- 11 Shuttle Rd
Farmington, CT 06032-1900 - Phone
- (860) 679-3980
- Fax
- (860) 679-1257
- NPI assigned
- Dec 16, 2020
- 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 |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | 42830 | CT | Primary |
Addresses
Primary practice location
11 Shuttle Rd
Farmington, CT 06032-1900
Mailing address
11 Shuttle Rd
Farmington, CT 06032-1900
Phone (860) 679-3980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42830 | CT | MD | Forensic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1417543240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SHUTTLE RD",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060321900",
"telephone_number": "860-679-3980",
"fax_number": "860-679-1257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 SHUTTLE RD",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060321900",
"telephone_number": "860-679-3980",
"fax_number": "860-679-1257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANGELISTA",
"first_name": "FRANK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-16",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "207ZF0201X",
"taxonomy_group": "",
"desc": "Pathology, Forensic Pathology",
"state": "CT",
"license": "42830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.