Individual provider Active NPI

Nicole Kristine Evankovich, PA

  • Surgical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1689869075
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
3380 Boulevard of the Allies
Suite 158
Pittsburgh, PA 15213-3125
Phone
(412) 648-8736
Fax
(412) 864-1733
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

3380 Boulevard of the Allies
Suite 158
Pittsburgh, PA 15213-3125

Mailing address

3380 Boulevard of the Allies
Suite 158
Pittsburgh, PA 15213-3125
Phone (412) 648-8736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20091009000168 PA Practitioner - Physician Assistant 8325138407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

300 Halket St
Pittsburgh, PA 15213-3108

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Sep 24, 2010 Accepting new patients
University of Pittsburgh Physicians CurrentSince Sep 24, 2010 Accepting new patients
Upmc Emergency Medicine Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1000 Bower Hill Rd
Pittsburgh, PA 15243
Phone (412) 344-6600

300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850

Interoperability endpoints

  • Direct secure messaging: nicole.k.evankovich@upmcdirect.com

Organizations & group practices 5

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1689869075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 BOULEVARD OF THE ALLIES",
            "address_2": "SUITE 158",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133125",
            "telephone_number": "412-648-8736",
            "fax_number": "412-864-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 BOULEVARD OF THE ALLIES",
            "address_2": "SUITE 158",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133125",
            "telephone_number": "412-648-8736",
            "fax_number": "412-864-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANKOVICH",
        "first_name": "NICOLE",
        "middle_name": "KRISTINE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.