NPIMap

Organization Active NPI

Evolve Health Partners

  • Adult Health Nurse Practitioner
  • Pasadena, MD
National Provider Identifier
1831834969
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
EVOLVE HEALTH PARTNERS
Practice address
2528 Mountain Rd Ste 101
Pasadena, MD 21122-7202
Phone
(443) 798-7778
Fax
(410) 360-1675
NPI assigned
May 3, 2022
Organization subpart
Yes
Parent organization
EVOLVE HEALTH PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Jessie Costley
Title
Administrator
Phone
(443) 548-3733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

2528 Mountain Rd Ste 101
Pasadena, MD 21122-7202

Mailing address

2528 Mountain Rd Ste 101
Pasadena, MD 21122-7202
Phone (443) 798-7778

Other identifiers 1

IdentifierTypeStateIssuer
317219800MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@evolvehealthpartnersmd.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230913003017 MD Part B Supplier - Clinic/Group Practice 2365806031 Receives reassigned benefits from 2 practitioners
Practice locations: Pasadena, MD

National Provider Directory

National Provider Directory
Tax ID family
Evolve Health Partners2 organizations share this tax ID, including this one
Part of
Evolve Health Partners

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2528 Mountain Rd
Ste 101
Pasadena, MD 21122
Phone (443) 798-7778

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1831834969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2528 MOUNTAIN RD STE 101",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227202",
            "telephone_number": "443-798-7778",
            "fax_number": "410-360-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2528 MOUNTAIN RD STE 101",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227202",
            "telephone_number": "443-798-7778",
            "fax_number": "410-360-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE HEALTH PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVOLVE HEALTH PARTNERS",
        "enumeration_date": "2022-05-03",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "COSTLEY",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "443-548-3733"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317219800",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@evolvehealthpartnersmd.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2528 Mountain Rd Ste 101",
            "city": "Pasadena",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211227202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.