Individual provider Active NPI

Evan Niakamal

  • Physician Assistant
  • Escondido, CA
National Provider Identifier
1639796873
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374
Phone
(760) 520-8340
NPI assigned
Jul 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374

Mailing address

16 Calle Alimar
Rancho Santa Margarita, CA 92688-2318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220308000553 CA Practitioner - Physician Assistant 7113311127 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58707CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Jan 10, 2022 Accepting new patients
Advanced Medical Psychiatric Services CurrentSince Dec 27, 2020 Accepting new patients
Neighborhood Healthcare CurrentSince Jan 10, 2022 Accepting new patients

Locations

3409 Calloway Dr
Ste 601
Bakersfield, CA 93312
Phone (661) 589-1200

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

425 N Date St
#0
Escondido, CA 92025

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1593820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1639796873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CALLE ALIMAR",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 E VALLEY PKWY STE 311",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253374",
            "telephone_number": "760-520-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIAKAMAL",
        "first_name": "EVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-04",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.