Individual provider Active NPI

Joshua Michael Evans, PA-C

  • Physician Assistant
  • Winter Park, FL
National Provider Identifier
1699484659
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116605 Issued in FL
Practice address
460 N Orlando Ave Ste 200
Winter Park, FL 32789-2988
Phone
(407) 898-5452
Fax
(844) 722-1185
NPI assigned
Nov 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9116605 FL Primary

Addresses

Primary practice location

460 N Orlando Ave Ste 200
Winter Park, FL 32789-2988

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221212000291 FL Practitioner - Physician Assistant 3779952908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Cancer Specialists and Research Institute, LLCGroup PAC ID 2567356058, 464 clinicians

Practice addresses (Care Compare)

460 N Orlando Ave
Suite 200 Building D
Winter Park, FL 32789-2920
Phone (407) 898-5452

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Nov 15, 2022 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

460 N Orlando Ave
Ste 200
Winter Park, FL 32789
Phone (407) 898-5452

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1699484659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N ORLANDO AVE STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892988",
            "telephone_number": "407-898-5452",
            "fax_number": "844-722-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOSHUA",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-18",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.