Individual provider Active NPI

Evan Henry Somers

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Hershey, PA
National Provider Identifier
1851634604
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
A154725 Issued in CA
Practice address
500 University Dr
McH159
Hershey, PA 17033-2360
Phone
(717) 531-8557
NPI assigned
Mar 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X A154725 CA Primary

Addresses

Primary practice location

500 University Dr
McH159
Hershey, PA 17033-2360

Mailing address

500 University Dr
McH159
Hershey, PA 17033-2360
Phone (717) 531-8557

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190819003999 CA Practitioner - Otolaryngology 9234439829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wake Forest University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011

1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A154725CAMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 16, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 16, 2018 Accepting new patients

Locations

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1851634604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "address_2": "MCH159",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "address_2": "MCH159",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERS",
        "first_name": "EVAN",
        "middle_name": "HENRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-30",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "CA",
            "license": "A154725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.