Active NPI
Karalyn Anne Evanco, PA
- Medical Physician Assistant
- Buffalo, NY
National Provider Identifier
1861875544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 018691
- Practice address
- 6 Fountain PLZ
Buffalo, NY 14202-2211 - Phone
- (716) 698-4493
- NPI assigned
- Jun 30, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 018691 | NY | Primary |
Addresses
Primary practice location
6 Fountain PLZ
Buffalo, NY 14202-2211
Mailing address
334 Washington Hwy
Snyder, NY 14226-4361
Phone (716) 698-4493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018691 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435622400000",
"number": "1861875544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 WASHINGTON HWY",
"city": "SNYDER",
"state": "NY",
"postal_code": "142264361",
"telephone_number": "716-698-4493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 FOUNTAIN PLZ",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142022211",
"telephone_number": "716-698-4493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANCO",
"first_name": "KARALYN",
"middle_name": "ANNE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-30",
"last_updated": "2015-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "018691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.