Individual provider Active NPI

Kevin Paul Evancic, PHARM D

  • Pharmacist
  • Pittsburgh, PA
National Provider Identifier
1417958539
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16500 Issued in NC
Practice address
799 Castle Shannon Blvd
Pittsburgh, PA 15234-1601
Phone
(124) 561-2417
Fax
(412) 561-7418
NPI assigned
Aug 10, 2005
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16500 NC Primary

Addresses

Primary practice location

799 Castle Shannon Blvd
Pittsburgh, PA 15234-1601

Mailing address

799 Castle Shannon Blvd
Pittsburgh, PA 15234-1601
Phone (124) 561-2417

Other practice location 1

25 Gill Hall Rd
Clairton, PA 15025-3004
Phone (412) 653-7566

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
16500NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasant Hills Apothecary Current Accepting new patients
Pleasant Hills RX LLC Current Accepting new patients
Pleasant Hills RX LLC Current Accepting new patients
Paladino Dachille and Laing Oral and Maxillofacial Surgery Assoc PC PastSince Nov 16, 2010 Accepting new patients

Locations

25 Gill Hall Rd
Jefferson Hls, PA 15025
Phone (412) 653-7400

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1417958539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 CASTLE SHANNON BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152341601",
            "telephone_number": "124-561-2417",
            "fax_number": "412-561-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 CASTLE SHANNON BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152341601",
            "telephone_number": "124-561-2417",
            "fax_number": "412-561-7418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Gill Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Clairton",
            "state": "PA",
            "postal_code": "150253004",
            "country_code": "US",
            "telephone_number": "412-653-7566",
            "fax_number": "412-653-0755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANCIC",
        "first_name": "KEVIN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "16500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.