Individual provider Active NPI

Evelyn Llanos, MD

  • Family Medicine Physician
  • Huntington, NY
National Provider Identifier
1760455497
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2381051 Issued in NY
Practice address
19 Southdown Rd
Huntington, NY 11743-2538
Phone
(631) 470-2572
Fax
(631) 423-9276
NPI assigned
Feb 13, 2006
Reactivated
Oct 24, 2007
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2381051 NY Primary

Addresses

Primary practice location

19 Southdown Rd
Huntington, NY 11743-2538

Mailing address

19 Southdown Rd
Huntington, NY 11743
Phone (631) 470-2572

Other identifiers 1

IdentifierTypeStateIssuer
02729913MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000712 NY Practitioner - Family Practice 9739193780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19 Southdown Rd
Huntington, NY 11743-2538
Phone (631) 470-9760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2381051NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evelyn Llanos MD PC Family Medicine CurrentSince Oct 2, 2007 Accepting new patients

Locations

124 Main St
Ste 16
Huntington, NY 11743
Phone (631) 423-7000

19 Southdown Rd
Huntington, NY 11743
Phone (631) 470-2572

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1760455497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SOUTHDOWN RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "631-470-2572",
            "fax_number": "631-385-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SOUTHDOWN RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432538",
            "telephone_number": "631-470-2572",
            "fax_number": "631-423-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLANOS",
        "first_name": "EVELYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2012-10-04",
        "deactivation_date": "2007-10-10",
        "reactivation_date": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "2381051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02729913",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.