Paul Vincent Castillo Evangelista, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0265291 Issued in NY

Practice address

13609 38TH Ave
Flushing, NY 11354-6500

Phone

(917) 400-2425

Fax

(718) 321-8115

NPI assigned

Jul 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Carolina Luna Care Physical Therapy LLCGroup PAC ID 8921418757, 66 clinicians

Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Duke University Health System, Inc.

  dba Duke University Hospital

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977
  Medicare reassignment Care Compare group
• North Carolina Luna Care Physical Therapy LLC

  • Physical Therapist
  • Hendersonville, NC
  • NPI 1124626148
  Medicare reassignment Care Compare group
• Yakov Raufov Medical PC

  • Specialist
  • Brooklyn, NY
  • NPI 1497839799
  NPD (past)
• Sports & More Physical Therapy, Inc.

  dba Access Physical Therapy & Wellness

  • Physical Therapist
  • Raleigh, NC
  • NPI 1134229669
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669495412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13609 38TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546500",
            "telephone_number": "917-400-2425",
            "fax_number": "718-321-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13609 38TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546500",
            "telephone_number": "917-400-2425",
            "fax_number": "718-321-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "PAUL VINCENT",
        "middle_name": "CASTILLO",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0265291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11625997",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amr Etman, MD
• Rachel Ettinger, PA-C
• Jan Aleksander Eubig, M.D.
• Eunhae Daycare Inc
• Euphoria Choice Servicesmanagement
• Michelle Evans, M.D.
• Sedef Everest, M.D.
• Evergreen Adult Day Care in Flushing Inc
• Evergreen Adult Day Care in New York CN
• Evergreen Adult Day Care in Ny, Inc

• Physical Therapist in Flushing, NY
• Providers in Flushing, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.