Individual provider Active NPI

Evan Schwartz, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Astoria, NY
National Provider Identifier
1811907017
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
150904-1 Issued in NY
Practice address
3016 30TH Dr Ste 1B
Park Lenox Orthopaedics, PC
Astoria, NY 11102-1890
Phone
(718) 558-1975
Fax
(718) 558-1617
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 150904-1 NY
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 150904-1 NY Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 150904-1 NY

Addresses

Primary practice location

3016 30TH Dr Ste 1B
Park Lenox Orthopaedics, PC
Astoria, NY 11102-1890

Mailing address

3016 30TH Dr Ste 1B
Park Lenox Orthopaedics, PC
Astoria, NY 11102-1890
Phone (718) 558-1975

Other identifiers 5

IdentifierTypeStateIssuer
068371OtherNYBLUE CROSS
01055398MedicaidNY
37909OtherAETNA
0006240OtherNYGHI
DS462OtherOXFORD

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
150904-1NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Lenox Orthopedics, PC Orthopaedic Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1811907017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 30TH DR STE 1B",
            "address_2": "PARK LENOX ORTHOPAEDICS, PC",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021890",
            "telephone_number": "718-558-1975",
            "fax_number": "718-558-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 30TH DR STE 1B",
            "address_2": "PARK LENOX ORTHOPAEDICS, PC",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021890",
            "telephone_number": "718-558-1975",
            "fax_number": "718-558-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "150904-1",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NY",
            "license": "150904-1",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "150904-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "068371",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01055398",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "37909",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0006240",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "DS462",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.