Individual provider Active NPI

Evgenios Evgeniou

  • Plastic Surgery Physician
  • Tampa, FL
National Provider Identifier
1861080046
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME159448 Issued in FL
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(888) 663-3488
NPI assigned
Jan 4, 2021
Last updated
Oct 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X BP10073091 TX
Plastic Surgery Physician 208200000X ME159448 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

PO Box 198441
Atlanta, GA 30384-8441

Other practice location 1

Ut Southwestern Medical Centre 1801 Inwood Road
Dallas, TX 75390-0001
Phone (214) 645-3117

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Evgenios.evgeniou@utsouthwestern.edu Direct
Direct Messaging Address Evgenios.Evgeniou@direct.moffitt.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221102000943 FL Practitioner - Plastic and Reconstructive Surgery 3072980150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10073091TXMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Oct 24, 2022 Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (888) 663-3488

Interoperability endpoints

  • Direct secure messaging: eevgeniou109988@direct.phhs.org
  • Direct secure messaging: evgenios.evgeniou@direct.moffitt.org

Organizations & group practices 1

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.

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": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1861080046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "888-663-3488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ut Southwestern Medical Centre 1801 Inwood Road",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753900001",
            "country_code": "US",
            "telephone_number": "214-645-3117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVGENIOU",
        "first_name": "EVGENIOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-04",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "BP10073091",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME159448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Evgenios.evgeniou@utsouthwestern.edu",
            "affiliation": "N",
            "endpointDescription": "Professional Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Ut Southwestern Medical Centre 1801 Inwood Road",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "753900001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Evgenios.Evgeniou@direct.moffitt.org",
            "affiliation": "N",
            "address_1": "12902 Usf Magnolia Dr",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336129416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.