Individual provider Active NPI

Eva Devorkin

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1679394910
Registry record updated Oct 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16069-33 Issued in WI
Practice address
3338 N Martin Luther King Dr
Milwaukee, WI 53212-1484
Phone
(414) 640-5433
NPI assigned
Oct 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16069-33 WI Primary

Addresses

Primary practice location

3338 N Martin Luther King Dr
Milwaukee, WI 53212-1484

Mailing address

3521 N 54TH Blvd
Milwaukee, WI 53216-2803
Phone (414) 731-8665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20241231000403 WI Practitioner - Nurse Practitioner 8820525934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shalem Healing IncGroup PAC ID 3577932292, 3 clinicians

Practice addresses (Care Compare)

3338 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-1484
Phone 41464054335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16069-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shalem Healing, Inc. Family CurrentSince Dec 24, 2024 Accepting new patients

Locations

3338 N Martin Luther King Dr
Milwaukee, WI 53212
Phone (414) 640-5433

3338 N Martin Luther King Dr
Fl 2
Milwaukee, WI 53212
Phone (414) 640-5433

Organizations & group practices 1

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": "1729296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1679394910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 N 54TH BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162803",
            "telephone_number": "414-731-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 N MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121484",
            "telephone_number": "414-640-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVORKIN",
        "first_name": "EVA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-19",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "16069-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.