Active NPI
Evan B Tepper, MD
- Pediatrics Physician
- Bradenton, FL
National Provider Identifier
1699717918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME60190
- Practice address
- 206 2ND St E
Bradenton, FL 34208-1042 - Phone
- (941) 746-5111
- NPI assigned
- Jun 12, 2006
- Last updated
- Mar 7, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME60190 | FL | Primary |
| General Practice Physician | 208D00000X | ME60190 | FL |
Addresses
Primary practice location
206 2ND St E
Bradenton, FL 34208-1042
Mailing address
14050 NW 14TH St
Suite 190
Sunrise, FL 33323-2865
Phone (800) 424-3672
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 372931101 | Medicaid | FL |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME60190 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Emergency Physicians Kang and Associates MD LLC | Emergency Medicine | Current | Accepting new patients |
| Susana Lozada-Murray, Psy.D. LLC | Current | Accepting new patients | |
| Inphynet Contracting Services LLC | Emergency Medicine | Past | Accepting new patients |
| Paragon Contracting Services LLC | Emergency Medicine | Past | Accepting new patients |
Locations
400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000
4728 N Habana Ave
Ste 302
Tampa, FL 33614
Phone (813) 556-2244
1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Emergency Medicine Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1699717918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14050 NW 14TH ST",
"address_2": "SUITE 190",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232865",
"telephone_number": "800-424-3672",
"fax_number": "954-377-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 2ND ST E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342081042",
"telephone_number": "941-746-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEPPER",
"first_name": "EVAN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME60190",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ME60190",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "372931101",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bradenton, FL
- Donald McGregor Teahan, PT,DPT,OCS,ATC,LAT
- Michael Tedla, MD
- Martha Ellen Teeter, AP LICENSED ACUPUNCT
- Koteshwar R Telukuntla, MD
- Christine Templeman, MA
- Leah Tepper
- Lauren M Terranova, D.O.
- Terrence T Hopkins MD, PA (Manatee Dermatology)
- Leigh Ann Tesar, ARNP
- Melanie Dawn Teves Bell, M.ED, ED.S., LMFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.