Active NPI
Edgar Sunglao Evangelista, NP
- Family Nurse Practitioner
- Glendora, CA
National Provider Identifier
1447770581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95006462
- Practice address
- 250 S Grand Ave
Glendora, CA 91741-4218 - Phone
- (626) 857-3299
- NPI assigned
- Jun 20, 2017
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95006462 | CA | Primary |
Addresses
Primary practice location
250 S Grand Ave
Glendora, CA 91741-4218
Mailing address
505 S Shellman Ave
San Dimas, CA 91773-3238
Phone (323) 363-3842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12900 Park Plaza Dr
Suite 700
Cerritos, CA 90703-9329
Phone (562) 622-2800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95006462 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albion Medical Partners of California West P C | Current | Accepting new patients |
Locations
12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800
12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800
Interoperability endpoints
- edgar.evangelista.p1@direct.caremorewest.nextgenshare.com
- edgar.evangelista.1@32527.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Cerritos, CA
- NPI 1073110607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497916800000",
"number": "1447770581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S SHELLMAN AVE",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917733238",
"telephone_number": "323-363-3842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 S GRAND AVE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917414218",
"telephone_number": "626-857-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANGELISTA",
"first_name": "EDGAR",
"middle_name": "SUNGLAO",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-20",
"last_updated": "2017-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95006462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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- Denise Estrada, B.S.
- Romelda Capitly Estrada, NP
- Michal Estrela, RN
- Jeri Lee Evans, B.S.
- Evergreen Natural Medicine and Acupuncture Corp.
- Evergreen Shop Pharmacy Inc
- Brittany Everson, DPM
- Eyenez Integrated Managed Eye Care Network, a Medical Group, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.