MICHAEL RICHARD EVANKOVICH (NPI# 1689621898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689621898 |
Entity Type | Individual |
Full Name | MICHAEL RICHARD EVANKOVICH |
Credential | MD |
Practice Address |
311 W 24th St Suite 101 Erie PA 16502-2665 |
Mailing Address |
311 W 24th St Ste 101 Erie PA 16502-2668 |
Practice Telephone | 8144524214 |
Practice Fax Number | 8144597823 |
Mailing Telephone | 8144524214 |
Mailing Fax Number | 8144597823 |
Enumeration Date | 2006-05-31 |
Last Update Date | 2020-10-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | MD060400L | PA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | BLUE SHIELD | 261978 | 01 |
PA | 0017973700003 | 05 | |
PA | RR MEDICARE | P00324768 | 01 |
NY | UNIVERA | 00025198402 | 01 |
PA | GATEWAY | 1041777 | 01 |
PA | AETNA | 1278964 | 01 |
NY | NY MEDICAL ASSISTANCE | 02079629 | 01 |
PA | UNISON | 182151 | 01 |
OH | OH MEDICAL ASSISTANCE | 2662659 | 01 |
PA | UPMC | 212543 | 01 |
Street Address |
311 W 24TH ST SUITE 101 |
City | ERIE |
State | PA |
Zip Code | 16502-2665 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013917814 | Edward C Clark | Internal Medicine | 311 W 24th St, Suite 402, Erie, PA 16502-2665 | 2005-07-22 |
1003477407 | Mary Katherine Lasher | Family Medicine | 311 W 24th St, Erie, PA 16502-2665 | 2019-06-26 |
1154857274 | Joseph Michael Krissel | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-05-10 |
1245764182 | Muhammad Samad Khan | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-04-18 |
1396279600 | Jessica Lerman | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-04-13 |
1497289821 | Joseph Datsko | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-04-12 |
1093257487 | Saint Vincent Medical Education and Research Inst. Inc | Podiatrist | 311 W 24th St, Suite 303, Erie, PA 16502-2665 | 2016-11-16 |
1447609847 | Tad Antognini | Family Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2016-06-07 |
1689022253 | Albert Tang | Family Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2016-05-24 |
1316391543 | Adam Fredrick Christensen | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2016-04-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679064794 | Fernando Torres | Specialist/Technologist | 549 1/2 W 7th St, Erie, PA 16502 | 2018-05-24 |
1548782907 | Michael Wayne Hankins Jr. | Podiatrist | 5515 Peach Street, Erie, PA 16502 | 2017-07-07 |
1730609041 | Michael Greg Palmer | Family Medicine | 311 West 24th Street 4th Floor, Erie, PA 16502 | 2017-06-27 |
1245658723 | Amy Adamus | Licensed Practical Nurse | 1647 Sassafras Street, Erie, PA 16502 | 2014-04-02 |
1295011088 | Margaret Gay Wardd | Licensed Practical Nurse | 1757 West 23 Street, Erie, PA 16502 | 2011-10-25 |
1659510782 | Kristen Kathleen Curry | Social Worker | 329 W. 10th St., Erie, PA 16502 | 2009-02-12 |
1699928416 | Kelly Cathleen Kelly-zazado | Social Worker | 301 W. 10th St., Lake Erie Counseling, Inc, Erie, PA 16502 | 2008-10-23 |
1922149350 | Wei-lung Sam Wu | Internal Medicine | Saint Vincent Professional Building, 311 West 24 Street, Suite 402, Erie, PA 16502 | 2007-02-09 |
1003970146 | Claire Donch | Psychologist | 301 West 10th Street, Erie, PA 16502 | 2006-12-21 |
1730703117 | Vincent Viet Ngo | Family Medicine | 311 West 24th Street, 4th Floor, Erie, PA 16502 | 2020-06-02 |
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Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043477334 | Lori Mae Dulabon | Urology | 5401 Peach St Ste 3600, Erie, PA 16509-2601 | 2008-05-22 |
1922031285 | Floyd M Csir | Urology | 311 West 24th St, Suite 101, Erie, PA 16502-2665 | 2006-07-09 |
1396778551 | Zdzislaw J Chorazy | Urology | 311 West 24th Street, Suite 101, Erie, PA 16502-2665 | 2006-07-09 |
1528026986 | Burkhardt H Zorn | Urology | 311 W 24th St Ste 101, Erie, PA 16502-2668 | 2006-05-03 |
1255325775 | Thomas Francis Walsh | Urology | 100 Peach St Ste 102, Erie, PA 16507-1423 | 2005-09-12 |
1295730695 | Justine Marut Schober | Urology | 300 State St Ste 301b, Erie, PA 16507-1430 | 2005-06-14 |
1871128447 | Millcreek Community Hospital | Urology | 5401 Peach St Ste 3600, Erie, PA 16509-2601 | 2020-03-04 |
1801288170 | Roy Scott Cooper | Urology | 100 Peach St Ste 102, Erie, PA 16507-1423 | 2015-02-24 |
1497094551 | Saint Vincent Medical Education and Research Institute | Urology | 311 W 24th St, Suite 101, Erie, PA 16502-2665 | 2013-02-11 |
1366768087 | Michael J Miller | Urology | 100 Peach St Ste 102, Erie, PA 16507-1423 | 2010-04-20 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.