Mary Jane Evangelista, PHD,DNP,PMHNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

209.027735 Issued in IL

Practice address

3900 N Pine Grove Ave Apt 414
Chicago, IL 60613-6641

Phone

(131) 291-2344

NPI assigned

Aug 4, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Heritage Medical Group IncGroup PAC ID 7517284029, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080

Merit-based Incentive Payment System (MIPS)

Final score

97.25 of 100Reported as group

Quality

80.59

Promoting interoperability

100

Improvement activities

40

Cost

76.91

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Pacific Heritage Medical Group Inc

  • Geriatric Psychiatry Physician
  • Westlake Village, CA
  • NPI 1467899450

  IL

  Medicare reassignment Care Compare group NPD
• Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Ranganathan T LTD

  • Psychiatry Physician
  • Desplaines, IL
  • NPI 1396385415
  Medicare reassignment NPD
• Bespoke Psychiatry

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1952937104
  Medicare reassignment
• Cook County

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170
  NPD
• Cook County

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• Ernest I. Watanabe, O.D. LTD.

  • Clinic/Center
  • Chicago, IL
  • NPI 1285818120
  NPD (past)
• Metropolitan Behavioral Associates, Inc.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1376039263
  NPD (past)

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

• Saint Francis Hospital - Evanston LLC

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1982442398
  Care Compare affiliation

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1720760010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 N PINE GROVE AVE APT 414",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136641",
            "telephone_number": "131-291-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N PINE GROVE AVE APT 414",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136641",
            "telephone_number": "131-291-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "MARY JANE",
        "name_prefix": "Mrs.",
        "credential": "PHD,DNP,PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.027735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camilo Evangelista, PT
• Christina Maria Evangelista, PHARMD
• Deeva Alexa Evangelista
• Evangelene Evangelista, COTA/L
• Joni Evangelista
• Andrew Evangelisti, DPM
• Anjelika Amaleah Evangelopoulos, M.D.
• Evans & Evans Counseling& Consulting Services Inc
• Kenyatta Evans-Snulligan, NP
• Allison Evans, OTD

• Primary Care Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Primary Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.
• 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.