Individual provider Active NPI

Evan Ward, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1841616679
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09131 Issued in TX
Practice address
1045 Gemini St Ste 100
Houston, TX 77058-2806
Phone
(281) 335-1111
Fax
(281) 286-9250
NPI assigned
Mar 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09131 TX Primary

Addresses

Primary practice location

1045 Gemini St Ste 100
Houston, TX 77058-2806

Mailing address

1045 Gemini St Ste 100
Houston, TX 77058-2806
Phone (281) 335-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141003001781 TX Practitioner - Physician Assistant 8820218399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marston Shaun Holt MD PAGroup PAC ID 1456534288, 14 clinicians

Practice addresses (Care Compare)

1045 Gemini St
Suite 100
Houston, TX 77058-2806
Phone (281) 335-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09131TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Mar 31, 2014 Accepting new patients
Ut Physicians Physician Assistant CurrentSince Mar 31, 2014 Accepting new patients

Locations

6400 Fannin St
Fl 17
Houston, TX 77030

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

Interoperability endpoints

  • Direct secure messaging: eward468882@direct.stlukeshealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1841616679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 GEMINI ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582806",
            "telephone_number": "281-335-1111",
            "fax_number": "281-286-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 GEMINI ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582806",
            "telephone_number": "281-335-1111",
            "fax_number": "281-286-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "EVAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-18",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.