Dr. Vincent Evangelista, DPM PC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

N004384 Issued in NY

Legal business name

DR. VINCENT EVANGELISTA, DPM PC

Practice address

9715 101St Ave
Ozone Park, NY 11416-2523

Phone

(718) 848-5700

Fax

(718) 323-0449

NPI assigned

Nov 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Vincent Evangelista, DPMNPI 1932152352

Title

President

Phone

(718) 848-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Vincent Evangelista, DPM

  • Primary Podiatric Medicine Podiatrist
  • Ozone Park, NY
  • NPI 1932152352
  Medicare reassignment NPD Authorized official
• Carl Eugene Vinciguerra, MD

  • General Practice Physician
  • Ozone Park, NY
  • NPI 1760451033
  NPD

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1841591955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9715 101ST AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162523",
            "telephone_number": "718-848-5700",
            "fax_number": "718-323-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 101ST AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162523",
            "telephone_number": "718-848-5700",
            "fax_number": "718-323-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. VINCENT EVANGELISTA, DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-848-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N004384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01120236",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dr. Osafradu Opam MD, PC
• Dr. Rudrama Duggirala Medical Services,PC
• Francina Drepaul, LMSW
• Duane Reade
• Rudrama Duggirala, MD
• Gladys Lucia Duma, LCSW
• Marta Dusi

• Primary Podiatric Medicine Podiatrist in Ozone Park, NY
• Providers in Ozone Park, NY by specialty
• Primary Podiatric Medicine Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.