NPIMap

Individual provider Active NPI

Karin E. Evan, M.D.

  • Otolaryngology Physician
  • Minneapolis, MN
National Provider Identifier
1508867003
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
38683 Issued in MN
Practice address
2211 Park Ave
Minneapolis, MN 55404-3711
Phone
(612) 871-1144
Fax
(612) 871-2012
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 38683 MN Primary

Addresses

Primary practice location

2211 Park Ave
Minneapolis, MN 55404-3711

Mailing address

2211 Park Ave
Minneapolis, MN 55404-3711
Phone (612) 871-1144

Other identifiers 8

IdentifierTypeStateIssuer
32249000OtherWIMEDICAID - WISCONSIN
88311OtherMNAMERICA'S PPO
1011275OtherMNPREFERREDONE
10-00010OtherMNMEDICA PRIMARY
616318100MedicaidMN
10-13362OtherMNMEDICA CHOICE
20A46EVOtherMNBLUE CROSS
113093OtherMNUCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100504000354 MN Practitioner - Otolaryngology 7315966553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Perelman School of Med at the University of Pennsylvania, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Specialty Care of Minnesota PAGroup PAC ID 3274524020, 46 clinicians

Practice addresses (Care Compare)

6099 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-5538
Phone (612) 871-1144

9822 Hospital Dr
Maple Grove, MN 55369-4648
Phone (612) 871-1144

Hospital & facility affiliations

  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Merit-based Incentive Payment System (MIPS)

Final score
77.11 of 100Reported as group
Quality
63.28
Promoting interoperability
91
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38683MNMDOtolaryngology Physician

Interoperability endpoints

  • Direct secure messaging: karin.evan@entsc.eclinicaldirectplus.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.

Hospital & facility affiliations 11

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1508867003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043711",
            "telephone_number": "612-871-1144",
            "fax_number": "612-871-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043711",
            "telephone_number": "612-871-1144",
            "fax_number": "612-871-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVAN",
        "first_name": "KARIN",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "38683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - WISCONSIN",
            "identifier": "32249000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "88311",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1011275",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "10-00010",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "616318100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "10-13362",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "20A46EV",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "113093",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.