Individual provider Active NPI

Evan Kingsley

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1598146961
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT209355 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-5435
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT209355 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20180525000231 PA Practitioner - Emergency Medicine 2668765587 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Pittsburgh School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services Current Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Jefferson Acute Care Physicians, PC Current Accepting new patients
Aria Health Physician Services CurrentSince Oct 1, 2019 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Dec 1, 2019 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Prospect Health Access Network, Inc. Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Aria Health Physician Services CurrentSince Oct 1, 2019 Accepting new patients
Jefferson University Physicians Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Dec 1, 2019 Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

1020 Sansom St
Ste 239
Philadelphia, PA 19107
Phone (215) 955-6844

2301 S Broad St
Fl 1
Philadelphia, PA 19148
Phone (215) 952-9136

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

175 E Chester Pike
Ridley Park, PA 19078
Phone (610) 595-6000

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 11

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 1

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1598146961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSLEY",
        "first_name": "EVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT209355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.