Individual provider Active NPI

Evan Schrader, MD

  • Obstetrics & Gynecology Physician
  • Orlando, FL
National Provider Identifier
1912535949
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME167942 Issued in FL
Practice address
83 W Miller St
Orlando, FL 32806-2031
Phone
(407) 898-6588
Fax
(407) 389-5312
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 261085 NC
Obstetrics & Gynecology Physician 207V00000X ME167942 FL Primary

Addresses

Primary practice location

83 W Miller St
Orlando, FL 32806-2031

Mailing address

83 W Miller St
Orlando, FL 32806-2031
Phone (407) 898-6588

Other practice location 1

1350 S Kings Dr Fl 3
Charlotte, NC 28207-2134
Phone (704) 446-1544

Other identifiers 1

IdentifierTypeStateIssuer
122426200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725002044 FL Practitioner - Obstetrics/Gynecology 5496178923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Florida State University College of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1201 W 38TH St
Austin, TX 78705-1006

1345 Philomena St
Austin, TX 78723-3210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
261085NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
Orlando Health Medical Group Inc Obstetrics & Gynecology CurrentSince Aug 1, 2024 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1912535949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062031",
            "telephone_number": "407-898-6588",
            "fax_number": "407-389-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062031",
            "telephone_number": "407-898-6588",
            "fax_number": "407-389-5312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "261085",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME167942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122426200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.