Mary L Evenson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1019-023 Issued in WI

Practice address

752 N High Point Rd
Dean Medical Center
Madison, WI 53717-2236

Phone

(608) 824-4000

Fax

(608) 824-4910

NPI assigned

Sep 16, 2005

Last updated

Dec 23, 2008By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1659366565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 N HIGH POINT RD",
            "address_2": "DEAN MEDICAL CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172236",
            "telephone_number": "608-824-4000",
            "fax_number": "608-824-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 N HIGH POINT RD",
            "address_2": "DEAN MEDICAL CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172236",
            "telephone_number": "608-824-4000",
            "fax_number": "608-824-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVENSON",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1019-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "60842",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42990900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Virginia A Evans, PA-C
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• Zachary Cole Even, MD
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• Evercare Health Services LLC (NA)
• Kristin Everett Lefel
• Evergreen Counseling Services, LLC
• Patricia Everhart, AD RN

• Medical Physician Assistant in Madison, WI
• Providers in Madison, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; 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.