Individual provider Active NPI

John H Evans, D.D.S

  • Prosthodontics
  • New York, NY
National Provider Identifier
1861588675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
038367-1 Issued in NY
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126001759 NY Practitioner - Oral Surgery 4789973652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038637NYMDGeneral Practice Dentistry
038367-1NYMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Oct 23, 2020 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Oct 23, 2020 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

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: 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.

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

Verify at the official NPI Registry.