NPIMap

Individual provider Active NPI

Evan P Cardin, PA-C

  • Physician Assistant
  • Brick, NJ
National Provider Identifier
1447888649
Registry record updated Apr 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00583700 Issued in NJ
Practice address
495 Jack Martin Blvd Ste 2
Brick, NJ 08724-7778
Phone
(732) 458-7575
NPI assigned
Apr 1, 2020
Last updated
Apr 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 25MP00583700 NJ Primary

Addresses

Primary practice location

495 Jack Martin Blvd Ste 2
Brick, NJ 08724-7778

Mailing address

495 Jack Martin Blvd Ste 2
Brick, NJ 08724-7778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20201123001645 NJ Practitioner - Physician Assistant 5991116956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Associates of Ocean CountyGroup PAC ID 7810886389, 5 clinicians

Practice addresses (Care Compare)

495 Jack Martin Blvd
Suite 2
Brick, NJ 08724-7778
Phone (732) 458-7575

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1447888649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 JACK MARTIN BLVD STE 2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 JACK MARTIN BLVD STE 2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247778",
            "telephone_number": "732-458-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDIN",
        "first_name": "EVAN",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00583700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.