Individual provider Active NPI

Nicholas Evageliou, M.D.

  • Pediatric Hematology & Oncology Physician
  • Philadelphia, PA
National Provider Identifier
1659401149
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
MD424577 Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Hem/Onc
Philadelphia, PA 19104-4319
Phone
(215) 590-3535
Fax
(215) 590-3992
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD424577 PA
Pediatric Hematology & Oncology Physician 2080P0207X MD424577 PA Primary
Pediatric Hematology & Oncology Physician 2080P0207X 25MA08612200 NJ

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Hem/Onc
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20070713000110 PA Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 1951401470 Reassigns benefits to 1 organization
I20091103000703 NJ Practitioner - Hematology/Oncology 1951401470 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08612200NJMDPediatric Hematology & Oncology Physician
MD424577PAMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Healthcare Associates of New Jersey PC Pediatrics CurrentSince Dec 7, 2010 Accepting new patients
Children'S Health Care Associates Pediatrics CurrentSince Aug 23, 2009 Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Dec 7, 2010 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Aug 23, 2009 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Past Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients

Locations

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

Organizations & group practices 8

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1659401149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9234",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - HEM/ONC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-3535",
            "fax_number": "215-590-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVAGELIOU",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD424577",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "PA",
            "license": "MD424577",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NJ",
            "license": "25MA08612200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.