Evan J Waldron, MD/PHD

Primary specialty

Clinical Pathology PhysicianTaxonomy code 207ZC0006X

License

327378 Issued in NY

Practice address

139 Watchung PL
Nutley, NJ 07110-2030

Phone

(201) 674-4944

Fax

(973) 661-4482

NPI assigned

Apr 14, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1912588740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 WATCHUNG PL",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102030",
            "telephone_number": "201-674-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 WATCHUNG PL",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102030",
            "telephone_number": "201-674-4944",
            "fax_number": "973-661-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "EVAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD/PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "NY",
            "license": "327378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Vivar
• Yeltsie Volcy
• Anna A Volkova, L.AC., PTA
• John L Volpe Jr., O.D.
• Vreeland Associates, LLC
• Walgreen Co (Rite Aid #1618)
• Derrick I Wallace, M.D.
• Su-Lai Wang, NP
• Wayne a. Armenti DMD PA (Nutley Dental)
• Samphena T Weah

• Clinical Pathology Physician in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.