Active NPI
Evelina Badalov, PA
- Physician Assistant
- Great Neck, NY
National Provider Identifier
1689704967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 011021
- Practice address
- 1010 Northern Blvd
Great Neck, NY 11021-5317 - Phone
- (516) 200-6305
- NPI assigned
- Mar 6, 2007
- Last updated
- Dec 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 011021 | NY | Primary |
Addresses
Primary practice location
1010 Northern Blvd
Great Neck, NY 11021-5317
Mailing address
1010 Northern Blvd
Great Neck, NY 11021-5317
Phone (506) 200-6305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011021 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emet Pharmacy LLC | Current | Accepting new patients | |
| Montefiore Medical Center | Past | Accepting new patients | |
| Madison Avenue Emergency Medicine PC | Past | Accepting new patients | |
| New York Cardiovascular Anesthesiologists, P.C. | Past | Accepting new patients |
Organizations & group practices 4
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.
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- Anesthesiology Physician
- Roslyn, NY
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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": "1766016000000",
"number": "1689704967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 NORTHERN BLVD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215317",
"telephone_number": "506-200-6305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 NORTHERN BLVD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215317",
"telephone_number": "516-200-6305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADALOV",
"first_name": "EVELINA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2025-12-18",
"certification_date": "2025-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "011021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.