CHARLIE EDWARD EVANS (MD) – Emergency Medicine Physician, NPI 1104875475

Emergency Medicine Physician

CHARLIE EDWARD EVANS (MD) is a healthcare provider. based in Ukiah, California. specializing in Emergency Medicine Physician. They hold the professional credentials MD. They hold a License No. G51002 (CA). The NPI Number for CHARLIE EDWARD EVANS (MD) is 1104875475

Main info

Male

44 Years Of Experience

Accepts Medicare Assignment

Name

CHARLIE EDWARD EVANS (MD)

NPI

1104875475

Phone

(707) 462-7900

Address

275 HOSPITAL DR

Enumeration Date

6 May 2006

Last Update Date

31 March 2008

Doctor Profile

Medical School Name

UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE

Secondary Phone

7077781111

Graduation Year

1982 (44 years ago)

PAC ID

7113824426

Group Practice PAC ID

2365478914

Professional Enrollment ID

I20080408000534

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience59

Completeness75

Years active:20State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for CHARLIE EDWARD EVANS (MD)

Adventist Health Ukiah Valley, 275, Hospital Drive, Downtown Ukiah, Ukiah, Mendocino County, California, 95482, United States
UKIAH, CA 954824531
Phone: (707) 462-7900
Fax: (707) 462-7947
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-04-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20080408000534	I	Emergency Medicine	CA	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95482)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 2365478914View full group profile

Name	Specialty	State
CHARLES KAPLOVE	-	CA
DR. HENRY LOREN FONG (M.D.)	-	CA
JOANNA KRYSTYNA RAMSEYER (MD)	-	CA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do payers reference CHARLIE EDWARD EVANS (MD)?

For CHARLIE EDWARD EVANS (MD), use NPI 1104875475 as the unique 10-digit identifier.

Active or inactive — what applies to CHARLIE EDWARD EVANS (MD)?

You should see CHARLIE EDWARD EVANS (MD) as active in CMS-hosted NPPES data.

How would a patient describe CHARLIE EDWARD EVANS (MD)'s focus?

For CHARLIE EDWARD EVANS (MD), the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.

What practice footprint exists for CHARLIE EDWARD EVANS (MD)?

Travel planning: use Ukiah, California as the reference point for CHARLIE EDWARD EVANS (MD), then confirm.

Does inactive status remove historical data?

Historical rows can remain visible after status changes — read the dates carefully.