Organization Active NPI

Evelyn Llanos MD PC

  • Family Medicine Physician
  • Huntington, NY
National Provider Identifier
1841319258
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2381051 Issued in NY
Legal business name
EVELYN LLANOS MD PC
Practice address
19 Southdown Rd
Suite 16
Huntington, NY 11743-2538
Phone
(631) 470-2572
Fax
(631) 385-1748
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Authorized official

Name
Dr. Evelyn Llanos, MDNPI 1760455497
Title
President
Phone
(631) 470-2572

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 2381051 NY Primary

Addresses

Primary practice location

19 Southdown Rd
Suite 16
Huntington, NY 11743-2538

Mailing address

19 Southdown Rd
Huntington, NY 11743-2538
Phone (631) 470-2572

Other identifiers 1

IdentifierTypeStateIssuer
02729913MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071002000623 NY Part B Supplier - Clinic/Group Practice 8527153857 Receives reassigned benefits from 5 practitioners
Practice locations: Huntington, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1057944Evelyn Llanos MD19 Southdown Road, Huntington, NY 11743Certificate of waiverAug 24, 2026

National Provider Directory

National Provider Directory

Locations

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

19 Southdown Rd
Ste 16
Huntington, NY 11743
Phone (631) 470-2572

Practitioners & affiliated clinicians

Practitioners 5

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": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1841319258",
    "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": "117432538",
            "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",
            "address_2": "SUITE 16",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432538",
            "telephone_number": "631-470-2572",
            "fax_number": "631-385-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN LLANOS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "LLANOS",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-470-2572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.