Jesus M Evangelista

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

154966 Issued in NY

Practice address

Wards Island
New York, NY 10035

Phone

(212) 427-9003

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528183365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GREENWOOD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WARDS ISLAND",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10035",
            "telephone_number": "212-427-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "JESUS",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "154966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154966",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan Rieder MD PC
• Jessica Lynn Evancho, LCAT, ATR-BC
• Vicky Evangelidis-Sakellson, DDS
• Megan A Evangelist, MSOTR/L
• April Pearl Evangelista, RN
• Laurelle Ann Evangelista, M.S.
• Maria Carmela Yu Sam Evangelista, NP
• Nancy Marie Evangelista, MSW
• John Evanko, M.D.
• Jennifer Lorine Evans Powis, LPC

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.