David Z Evdokimow, M.D.

Primary specialty

Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X

License

25MA07315300 Issued in NJ

Practice address

96 S Finley Ave
Basking Ridge, NJ 07920-1422

Phone

(908) 221-1136

Fax

(908) 221-0482

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hospitalists Emo, LLC

  • Hospitalist Physician
  • Livingston, NJ
  • NPI 1275575623
  NPD (past)
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1508930678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 S FINLEY AVE",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201422",
            "telephone_number": "908-221-1136",
            "fax_number": "908-221-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 S FINLEY AVE",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201422",
            "telephone_number": "908-221-1136",
            "fax_number": "908-221-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVDOKIMOW",
        "first_name": "DAVID",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "25MA07315300",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA07315300",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NJ",
            "license": "25MA07315300",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "NJ",
            "license": "25MA07315300",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NJ",
            "license": "25MA07315300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azita Emami, DDS
• Empowherment Collective
• Kayla Epple, PA-C
• Rajalakshmy Ernazath-Vengali
• Eric L Estonilo, NP-C
• Eye for Health, LLC
• Linda Nadine Fagan, MD
• Sam S. Faltas, D.D.S.
• Domenica Alexandra Fantini, D.O.
• Homa Faridnia, DDS

• Surgery of the Hand (Plastic Surgery) Physician in Basking Ridge, NJ
• Providers in Basking Ridge, NJ by specialty
• Surgery of the Hand (Plastic Surgery) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.