Individual provider Active NPI

Eduardo A. Cevallos, M.D.

  • Pediatrics Physician
  • Quakertown, PA
National Provider Identifier
1790754687
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD016392E Issued in PA
Practice address
99 N West End Blvd Ste 110
Quakertown, PA 18951
Phone
(215) 536-1915
Fax
(215) 536-9189
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD016392E PA Primary

Addresses

Primary practice location

99 N West End Blvd Ste 110
Quakertown, PA 18951

Mailing address

99 N West End Blvd Ste 110
Quakertown, PA 18951-1272
Phone (215) 536-1915

Other identifiers 1

IdentifierTypeStateIssuer
0006340100001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD016392EPAMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: eduardo.cevallos@slpg.direct-sluhn.org

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1790754687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 N WEST END BLVD STE 110",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189511272",
            "telephone_number": "215-536-1915",
            "fax_number": "215-536-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 N WEST END BLVD STE 110",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "18951",
            "telephone_number": "215-536-1915",
            "fax_number": "215-536-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEVALLOS",
        "first_name": "EDUARDO",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD016392E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006340100001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quakertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.