Individual provider Active NPI

Evan John Johnson, M.D.

  • Vascular & Interventional Radiology Physician
  • Seattle, WA
National Provider Identifier
1639462450
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD61165996 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-0001
Phone
(206) 520-5000
NPI assigned
May 26, 2011
Last updated
Apr 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME130781 FL
Diagnostic Radiology Physician 2085R0202X MD61165996 WA
Diagnostic Radiology Physician 2085R0202X C1-0027435 DE
Diagnostic Radiology Physician 2085R0202X V3501 TX
Diagnostic Radiology Physician 2085R0202X 76783 TN
Vascular & Interventional Radiology Physician 2085R0204X V3501 TX
Vascular & Interventional Radiology Physician 2085R0204X MD61165996 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-0001

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other practice location 1

4755 Ogletown Stanton Road
Newark, DE 19718-2200
Phone (302) 733-1840

Other practice location 2

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (855) 674-4624

Other practice location 3

7211 Wellington Dr Ste 101
Knoxville, TN 37919-5968
Phone (865) 588-8005

Other practice location 4

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (855) 674-4624

Other practice location 5

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000

Other practice location 6

901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431

Other practice location 7

11995 Singletree Ln Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301

Other practice location 8

875 S Route 31
Crystal Lake, IL 60014-8190
Phone (779) 220-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, IL, TX, MI, DE, NY, CA, NM, SC, TN, NC, FL12 enrollments
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 12

Enrollment IDStateProvider typePAC IDDetails
I20210729002673 WA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 24 organizations
I20240910001638 IL Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 5 organizations
I20241002002527 TX Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 5 organizations
I20241022004363 MI Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 1 organization
I20241105002328 DE Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 1 organization
I20241127000797 NY Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 2 organizations
I20241220001374 CA Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 1 organization
I20250102001606 NM Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 3 organizations
I20260223003838 SC Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 1 organization
I20260227000154 TN Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 1 organization
I20260328000324 NC Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 1 organization
I20260406002525 FL Practitioner - Diagnostic Radiology 2466708763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Florida State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Texas Radiological Associates PAGroup PAC ID 4385740141, 61 clinicians
Humboldt Park HealthGroup PAC ID 8921907072, 106 clinicians
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians
Bayhealth Radiologists LLCGroup PAC ID 0446601876, 91 clinicians
Pco PCGroup PAC ID 5395179329, 82 clinicians
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians
Central Valley Community Medical ImagingGroup PAC ID 5799679874, 97 clinicians
Lubbock County Hospital DistrictGroup PAC ID 4385538941, 97 clinicians
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians
Thorek Radiology Group NFPGroup PAC ID 1658786421, 41 clinicians
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians
Grays Harbor Community HospitalGroup PAC ID 3577462365, 91 clinicians

Practice addresses (Care Compare)

Lake Forest Park, WA 98155
Phone (903) 663-4800

1044 N Francisco Ave
Chicago, IL 60622-2743
Phone (773) 292-8227

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1215 E Michigan Ave
Unitversity of Michigan Health Spar
Lansing, MI 48912-1811
Phone (517) 364-5650

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

16262 38TH Ave NE
Lake Forest Park, WA 98155-5417
Phone (302) 744-7113

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

3603 W 48TH Ave
Kennewick, WA 99337-2721
Phone (302) 892-8889

3762 Tibbetts St
Riverside, CA 92506-2605
Phone (951) 686-2224

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 838-3088

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-8400

603 S Chestnut St
Ellensburg, WA 98926-3875
Phone (509) 962-9841

6901 Medical Pkwy
Waco, TX 76712-7910
Phone (254) 751-4000

7211 Wellington Dr
Suite 101
Knoxville, TN 37919-5968
Phone (865) 558-9822

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000

850 W Irving Park Rd
Chicago, IL 60613-3077
Phone (773) 975-6722

875 S Route 31
Crystal Lake, IL 60014-8190
Phone (779) 220-5500

915 Anderson Dr
Aberdeen, WA 98520-1006
Phone (360) 532-8330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0027435DEMDDiagnostic Radiology Physician
ME130781FLMDDiagnostic Radiology Physician
76783TNMDDiagnostic Radiology Physician

Practice roles (60 of 64)

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Nov 16, 2024 Accepting new patients
The Association of University Physicians Diagnostic Radiology CurrentSince Jul 22, 2021 Accepting new patients
Ochiltree Hospital District CurrentSince Oct 1, 2025 Accepting new patients
Rockford Health Physicians CurrentSince Sep 1, 2025 Accepting new patients
Ochiltree Hospital District Current Accepting new patients
Lubbock County Hospital District Diagnostic Radiology CurrentSince Nov 18, 2024 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Apr 1, 2023 Accepting new patients
Optumcare New Mexico LLC CurrentSince Feb 16, 2026 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Chelan County Public Hospital District No 2 CurrentSince Feb 1, 2024 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Oct 11, 2024 Accepting new patients
Grays Harbor Community Hospital Current Accepting new patients
Montclair Radiological Assoc ,PA Diagnostic Radiology CurrentSince Sep 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Colonial Family Practice, LLC CurrentSince Feb 1, 2026 Accepting new patients
Ochiltree Hospital District CurrentSince Oct 1, 2025 Accepting new patients
Empire State Radiology P C Diagnostic Radiology CurrentSince May 21, 2025 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Oct 11, 2024 Accepting new patients
El Paso County Hospital District CurrentSince Sep 19, 2024 Accepting new patients
Bayhealth Radiologists LLC Diagnostic Radiology CurrentSince Oct 1, 2024 Accepting new patients
Central Valley Community Medical Imaging Diagnostic Radiology CurrentSince Aug 20, 2024 Accepting new patients
Klickitat County Public Hospital District No 1 Current Accepting new patients
Warren General Hospital CurrentSince Dec 8, 2024 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Lubbock County Hospital District Diagnostic Radiology Current Accepting new patients
Interfaith Professional Physician Services, P.C. Diagnostic Radiology CurrentSince Oct 1, 2024 Accepting new patients
Grays Harbor Community Hospital CurrentSince Oct 11, 2024 Accepting new patients
Colonial Family Practice, LLC CurrentSince Feb 1, 2026 Accepting new patients
Nor-Lea Hospital District CurrentSince Nov 21, 2024 Accepting new patients
Ochiltree Hospital District CurrentSince Oct 1, 2025 Accepting new patients
Summit Medical Group, PLLC CurrentSince Feb 3, 2026 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Apr 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm Diagnostic Radiology CurrentSince Nov 16, 2024 Accepting new patients
Chelan County Public Hospital District No 2 Current Accepting new patients
Thorek Radiology Group NFP Diagnostic Radiology CurrentSince Feb 15, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Sep 1, 2025 Accepting new patients
El Paso County Hospital District CurrentSince Sep 19, 2024 Accepting new patients
Edward W Sparrow Hospital Association Vascular & Interventional Radiology Current Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Dec 5, 2024 Accepting new patients
Summit Medical Group, PLLC CurrentSince Feb 3, 2026 Accepting new patients
Mercy Health System Corporation CurrentSince Sep 1, 2025 Accepting new patients
Riverside Radiology Medical Group Inc Diagnostic Radiology CurrentSince Aug 13, 2024 Accepting new patients
On-Line Radiology Medical Group Inc Diagnostic Radiology CurrentSince Aug 10, 2024 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Dec 5, 2024 Accepting new patients
Humboldt Park Health CurrentSince Aug 27, 2024 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Warren General Hospital Diagnostic Radiology CurrentSince Dec 8, 2024 Accepting new patients
Chelan County Public Hospital Dist No 2 CurrentSince Feb 1, 2024 Accepting new patients
Central Texas Radiological Associates PA Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Radiology Alliance PC Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Christiana Care Health Services Inc CurrentSince Sep 22, 2024 Accepting new patients
Pco PC Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Nor-Lea Hospital District CurrentSince Nov 21, 2024 Accepting new patients
Radiology Associates of Albuquerque, PA Diagnostic Radiology CurrentSince Dec 18, 2024 Accepting new patients
Grays Harbor Surgeons CurrentSince Oct 11, 2024 Accepting new patients
Dickinson County Healthcare System Diagnostic Radiology CurrentSince Mar 28, 2026 Accepting new patients
Red River Consultants, Inc Diagnostic Radiology CurrentSince Apr 24, 2024 Accepting new patients
Geisinger-HM Joint Venture LLC Diagnostic Radiology Current Accepting new patients
Christiana Care Health Services Inc Diagnostic Radiology CurrentSince Sep 22, 2024 Accepting new patients
Thorek Memorial Hospital Current Accepting new patients

Locations (25 of 49)

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

4500 Brockton Ave
Ste 219
Riverside, CA 92501
Phone (951) 276-7550

4510 Brockton Ave
Ste 175
Riverside, CA 92501
Phone (951) 786-5100

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

2741 Paysphere Cir
Chicago, IL 60674

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

8175 Reliable Pkwy
Chicago, IL 60686

875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

901 Grant St
Harvard, IL 60033
Phone (815) 943-2961

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

1200 E Michigan Ave
Fl 1
Lansing, MI 48912

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1215 E Michigan Ave
Fl 4
Lansing, MI 48912
Phone (517) 364-3480

777 Passaic Ave
Ste 360
Clifton, NJ 07012

20 High St
Nutley, NJ 07110
Phone (973) 281-1881

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 69

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 69

Hospital & facility affiliations 6

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": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1639462450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 OGLETOWN STANTON ROAD",
            "address_purpose": "LOCATION",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-733-1840",
            "fax_number": "302-733-1633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13813 Metro Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124343",
            "country_code": "US",
            "telephone_number": "855-674-4624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7211 Wellington Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379195968",
            "country_code": "US",
            "telephone_number": "865-588-8005",
            "fax_number": "865-588-7716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13813 Metro Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124343",
            "country_code": "US",
            "telephone_number": "855-674-4624",
            "fax_number": "941-883-8386",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Grant St",
            "address_purpose": "LOCATION",
            "city": "Harvard",
            "state": "IL",
            "postal_code": "600331821",
            "country_code": "US",
            "telephone_number": "815-943-5431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11995 Singletree Ln Ste 500",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553445349",
            "country_code": "US",
            "telephone_number": "952-595-1301",
            "fax_number": "612-249-4903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 S Route 31",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600148190",
            "country_code": "US",
            "telephone_number": "779-220-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EVAN",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-26",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME130781",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD61165996",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DE",
            "license": "C1-0027435",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "V3501",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "76783",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "V3501",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD61165996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.