EDGAR SUNGLAO EVANGELISTA (NP) – Family Nurse Practitioner, NPI 1447770581

EDGAR SUNGLAO EVANGELISTA (NP) is a healthcare provider. based in San dimas, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 95006462 (CA). The NPI Number for EDGAR SUNGLAO EVANGELISTA (NP) is 1447770581

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
EDGAR SUNGLAO EVANGELISTA (NP)
NPI
1447770581
Phone
(323) 363-3842
Address
505 S SHELLMAN AVE
Enumeration Date
20 June 2017
Last Update Date
20 June 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5626222800
Graduation Year
2016 (10 years ago)
PAC ID
3870850233
Group Practice PAC ID
8921419813
Professional Enrollment ID
I20201119000960
Address ID
CA907039329CE12900DRXX417
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

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Provider Addresses for EDGAR SUNGLAO EVANGELISTA (NP)

  • 505, South Shellman Avenue, San Dimas, Los Angeles County, California, 91773, United States

    SAN DIMAS, CA 917733238

    Phone: (323) 363-3842

    Type: Mailing

  • Foothill Presbyterian Hospital, 250, South Grand Avenue, Glendora, Los Angeles County, California, 91741, United States

    GLENDORA, CA 917414218

    Phone: (626) 857-3299

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-05-11 • Largest payer in this snapshot: Biogen, Inc. ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Biogen, Inc.$20
View all Open Payments →|Open Payments Risk Radar →

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: 2020-11-19

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

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201119000960INurse PractitionerCATBD

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 91773)

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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: 8921419813View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)CA
Internal MedicineCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA

Reviews

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Frequently asked questions

Is there an official ID for EDGAR SUNGLAO EVANGELISTA (NP) in U.S. healthcare records?
The official identifier for EDGAR SUNGLAO EVANGELISTA (NP) is NPI 1447770581.
Would EDGAR SUNGLAO EVANGELISTA (NP) appear as active to a payer?
You can treat EDGAR SUNGLAO EVANGELISTA (NP) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is EDGAR SUNGLAO EVANGELISTA (NP)?
EDGAR SUNGLAO EVANGELISTA (NP) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is EDGAR SUNGLAO EVANGELISTA (NP) associated with San Dimas?
Public fields place EDGAR SUNGLAO EVANGELISTA (NP) around San Dimas, California. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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