Individual provider Active NPI

Evan C Speck, MD

  • Anesthesiology Physician
  • Evansville, IN
National Provider Identifier
1679502777
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01041146A Issued in IN
Practice address
600 Mary St
Evansville, IN 47747-0001
Phone
(812) 450-2240
Fax
(812) 450-2710
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01041146A IN Primary

Addresses

Primary practice location

600 Mary St
Evansville, IN 47747-0001

Mailing address

PO Box 3366
Evansville, IN 47732-3366
Phone (812) 450-2240

Other identifiers 2

IdentifierTypeStateIssuer
100242910MedicaidIN
64877178MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000535 IN Practitioner - Anesthesiology 2466467477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
82.57
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01041146AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Current Accepting new patients
Deaconess Hospital, Inc Anesthesiology CurrentSince Mar 26, 2018 Accepting new patients
Deaconess Hospital Inc CurrentSince Mar 26, 2018 Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1679502777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3366",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477323366",
            "telephone_number": "812-450-2240",
            "fax_number": "812-450-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477470001",
            "telephone_number": "812-450-2240",
            "fax_number": "812-450-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECK",
        "first_name": "EVAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01041146A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100242910",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64877178",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.