Mary K Evangelista, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71007197A Issued in IN

Practice address

4321 Fir St
East Chicago, IN 46312-3049

Phone

(219) 765-0597

NPI assigned

Jun 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary K Anderson Former name

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Premise Health of Indiana Medical, P.C.

  • Family Medicine Physician
  • Chesterton, IN
  • NPI 1942363841
  Medicare reassignment NPD
• The Methodist Hospitals, Inc

  • Internal Medicine Physician
  • Gary, IN
  • NPI 1720290349
  Medicare reassignment NPD
• Premise Health of Illinois Medical PC

  • Primary Care Clinic/Center
  • Mount Vernon, IL
  • NPI 1427366921
  Medicare reassignment NPD
• One Doc PLLC

  • Family Medicine Physician
  • West Lafayette, IN
  • NPI 1265968549
  NPD
• The Methodist Hospitals, Inc

  • Neurology Physician
  • Gary, IN
  • NPI 1720290588
  NPD
• Premise Health of Illinois Medical PC

  • Multi-Specialty Clinic/Center
  • Countryside, IL
  • NPI 1083006001
  NPD
• Premise Health of Illinois Medical PC

  • Multi-Specialty Clinic/Center
  • Utica, IL
  • NPI 1295518868
  NPD
• Connecticut General Life Insurance Company

  • Clinic/Center
  • Hammond, IN
  • NPI 1255757332
  NPD (past)

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1881114767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 FIR ST",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123049",
            "telephone_number": "219-392-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 FIR ST",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123049",
            "telephone_number": "219-765-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007197A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ANDERSON",
            "middle_name": "K",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hilda Emelogu
• Emergency Medical Services, PC
• Emergency Physician Associates of Indiana PC
• Angelia Marie Erb, LCSW
• Dana Claire Erickson, MSW
• Roderick Bertram Ewing Sr.
• Familia Dental Ec LLC
• Family Life Consultants, Inc
• Diane Barbara Fedak, BA
• Tenisha Lashay Fennie

• Family Nurse Practitioner in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.

Verify at the official NPI Registry.