Individual provider Active NPI

Dennis W Evangelatos, M.D.

  • Internal Medicine Physician
  • Beverly Hills, CA
National Provider Identifier
1477588663
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G50929 Issued in CA
Practice address
120 S Spalding Dr
Suite 403
Beverly Hills, CA 90212-1800
Phone
(424) 239-2400
Fax
(424) 239-2403
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G50929 CA Primary

Addresses

Primary practice location

120 S Spalding Dr
Suite 403
Beverly Hills, CA 90212-1800

Mailing address

120 S Spalding Dr
Suite 403
Beverly Hills, CA 90212-1800
Phone (424) 239-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2015 through Apr 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50929CAMDGeneral Practice Dentistry
G50929CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1477588663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S SPALDING DR",
            "address_2": "SUITE 403",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121800",
            "telephone_number": "424-239-2400",
            "fax_number": "424-239-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S SPALDING DR",
            "address_2": "SUITE 403",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121800",
            "telephone_number": "424-239-2400",
            "fax_number": "424-239-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELATOS",
        "first_name": "DENNIS",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G50929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.