Jonald Boyles Evangelista, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4240 Issued in NV

Practice address

3157 Fairlane Dr
Allen Park, MI 48101-2866

Phone

(313) 827-0099

Fax

(313) 749-0480

NPI assigned

Nov 13, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Rehabilitation Specialists of Fowlerville LLCGroup PAC ID 6204730393, 125 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.78 of 100Reported as group

Quality

89.5

Improvement activities

40

Cost

71.87

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23033/brand/1/csg/1/fhir/r4

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.

• Michigan Rehabilitation Specialists of Fowlerville LLC

  • Physical Therapist
  • Fowlerville, MI
  • NPI 1669531166
  Medicare reassignment Care Compare group NPD
• Michigan Rehabilitation Specialists of Fowlerville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Dexter, MI
  • NPI 1407525892
  NPD
• Kalter Physical Medicine & Rehabilitation PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Smithtown, NY
  • NPI 1720526999
  NPD (past)
• MK Spine and Joint Rehab, P.C.

  • Pain Clinic/Center
  • Hauppauge, NY
  • NPI 1699239715
  NPD (past)

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1770128746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3157 FAIRLANE DR",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012866",
            "telephone_number": "313-827-0099",
            "fax_number": "313-749-0480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 N Tenaya Way Ste 180",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891281110",
            "country_code": "US",
            "telephone_number": "702-240-2952",
            "fax_number": "702-243-0482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "JONALD",
        "middle_name": "BOYLES",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032653",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.