Jose S Evangelista III MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

05865R Issued in MI

Legal business name

JOSE S EVANGELISTA III MD PC

Practice address

7071 Orchard Lake Rd
Suite 333
West Bloomfield, MI 48322-3613

Phone

(248) 890-9995

NPI assigned

Oct 27, 2014

Organization subpart

No

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

Authorized official

Name

Jose S Evangelista III, MDNPI 1306029186

Title

Owner

Phone

(248) 890-9995

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jose Salgado Evangelista III, MD

  • Pulmonary Disease Physician
  • West Bloomfield, MI
  • NPI 1306029186
  Medicare reassignment Care Compare group Authorized official
• Leila Lee, ANP-BC

  • Adult Medicine Physician
  • Royal Oak, MI
  • NPI 1609250133
  Medicare reassignment Care Compare group NPD
• Douglas Clayton Kinney, ACNP

  • Acute Care Nurse Practitioner
  • West Bloomfield, MI
  • NPI 1487902474
  Medicare reassignment NPD
• Samantha Joanne Peszko, NP

  • Family Nurse Practitioner
  • Royal Oak, MI
  • NPI 1922690577
  Medicare reassignment NPD
• Jessica Taher, NP

  • Nurse Practitioner
  • Novi, MI
  • NPI 1639916844
  Medicare reassignment NPD

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1871998385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7071 ORCHARD LAKE RD",
            "address_2": "SUITE 333",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223613",
            "telephone_number": "248-890-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7071 ORCHARD LAKE RD",
            "address_2": "SUITE 333",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223613",
            "telephone_number": "248-890-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE S EVANGELISTA III MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-890-9995",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "05865R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahad Raad Jonna, PA-C
• Christopher Joppie, LMT
• Becky S Jordan
• Christina Jordan
• Rola Jordan
• Ashley Ruth Josifoski, PA-C
• JPK Home Care
• Judith Thurswell, PSYD, LP
• Judith Thurswell, PSYD, PLLC
• Julio M. Sosa MD PC

• Internal Medicine Physician in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.