Organization Active NPI

Frank a Evanov MD PC

  • Internal Medicine Physician
  • New Hyde Park, NY
National Provider Identifier
1679897631
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FRANK A EVANOV MD PC
Practice address
1300 Union Tpke
New Hyde Park, NY 11040-1759
Phone
(516) 352-1500
Fax
(516) 352-1453
NPI assigned
Mar 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Dr. Frank Evanov, MDNPI 1750362984
Title
President
Phone
(516) 352-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 124049 NY

Addresses

Primary practice location

1300 Union Tpke
New Hyde Park, NY 11040-1759

Mailing address

1300 Union Tpke
New Hyde Park, NY 11040-1759
Phone (516) 352-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100611000056 NY Part B Supplier - Clinic/Group Practice 8022148436 Receives reassigned benefits from 1 practitioner
Practice locations: New Hyde Park, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0143658Frank Evanov MD1300 Union Tpke, New Hyde Park, NY 11040Certificate of waiverJul 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Frank a Evanov MD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1679897631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 UNION TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401759",
            "telephone_number": "516-352-1500",
            "fax_number": "516-352-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 UNION TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401759",
            "telephone_number": "516-352-1500",
            "fax_number": "516-352-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANK A EVANOV MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "EVANOV",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-352-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "124049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.