Gina Marie Evangelista, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

New York Spine and Brain Surgery HSC T12 RM 080
Stony Brook, NY 11794-0001

Phone

(631) 444-1116

Fax

(631) 444-1535

NPI assigned

Jul 20, 2021

Last updated

Jul 25, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: gevangelista2267108@nychhc.direct-ci.com
• Direct secure messaging: gina.evangelista@direct.stonybrookmedicine.edu
• Direct secure messaging: mia9198@direct.nyp.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1881267763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BULLARD ST",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119504702",
            "telephone_number": "631-827-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEW YORK SPINE AND BRAIN SURGERY HSC T12 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-1116",
            "fax_number": "631-444-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liza Escobar, NP
• Rachel Shayna Eshtiaghpour, DDS
• Tasiyah Essop, MD
• Danielle Esteban, DO
• Chelsea Estrada, D.O.
• Andrew Colin Everett, DDS
• Jacquelyn Ann Faber, DPT
• Fredric Francis Fabiano
• Morgane Giordano Factor, MD
• Abagael Fagan, WHNP-BC

• Physician Assistant in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.