Anthony William Evangelista, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

K0028 Issued in TX

Practice address

350 E Interstate 20
Arlington, TX 76018-1119

Phone

(817) 784-0222

Fax

(817) 467-5819

NPI assigned

Jun 13, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1851361471
  NPD
• Staten Island Physician Practice PC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568413169

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1922002302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103941",
            "telephone_number": "720-524-1001",
            "fax_number": "720-524-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181119",
            "telephone_number": "817-784-0222",
            "fax_number": "817-467-5819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 N Gun Barrel Ln",
            "address_purpose": "LOCATION",
            "city": "Gun Barrel City",
            "state": "TX",
            "postal_code": "751563732",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "817-417-0981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 E Southlake Blvd",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760926501",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "817-417-0981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3645 Dallas Pkwy Ste 545",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938167",
            "country_code": "US",
            "telephone_number": "214-440-5200",
            "fax_number": "214-440-5201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2007 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "TX",
            "postal_code": "754552336",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "817-417-0981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5494 Glen Lakes Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752314308",
            "country_code": "US",
            "telephone_number": "214-692-6220",
            "fax_number": "214-696-1579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "ANTHONY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "K0028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P088X3726",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.