Individual provider Active NPI

Philip Santiago Evangelista, PHYSICAL THERAPIST

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1962286914
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304734 Issued in CA
Practice address
1500 Owens St Ste 400
San Francisco, CA 94158-2335
Phone
(415) 353-7598
NPI assigned
Aug 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 304734 CA Primary

Addresses

Primary practice location

1500 Owens St Ste 400
San Francisco, CA 94158-2335

Mailing address

1500 Owens St Ste 400
San Francisco, CA 94158-2335
Phone (415) 353-7598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304734CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1962286914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 OWENS ST STE 400",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582335",
            "telephone_number": "415-353-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OWENS ST STE 400",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582335",
            "telephone_number": "415-353-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "PHILIP",
        "middle_name": "SANTIAGO",
        "name_prefix": "Dr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.