Active NPI
John H Evans, D.D.S
- Prosthodontics
- New York, NY
National Provider Identifier
1861588675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 038367-1
- Practice address
- 128 Fort Washington Ave
Suite 1J
New York, NY 10032 - Phone
- (212) 928-1000
- Fax
- (212) 928-1094
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 038367-1 | NY | Primary |
Addresses
Primary practice location
128 Fort Washington Ave
Suite 1J
New York, NY 10032
Mailing address
38 Holly Drive
New Rochelle, NY 10801
Phone (914) 712-7452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038637 | NY | MD | General Practice Dentistry |
| 038367-1 | NY | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Past | Accepting new patients | |
| Columbia University Health Care, Inc. | Past | Accepting new patients |
Locations
630 W 168th St
Ph 7
New York, NY 10032
Phone (212) 305-6741
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 4
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.
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
- Dental Clinic/Center
- New York, NY
- NPI 1114432671
-
- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861588675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 HOLLY DRIVE",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "10801",
"telephone_number": "914-712-7452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 FORT WASHINGTON AVE",
"address_2": "SUITE 1J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10032",
"telephone_number": "212-928-1000",
"fax_number": "212-928-1094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JOHN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "038367-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.