JONATHAN EVANS (DPT) – Orthopedic Physical Therapist, NPI 1033493622

JONATHAN EVANS (DPT) is a healthcare provider. based in Fort wayne, Indiana. specializing in Orthopedic Physical Therapist. They hold the professional credentials DPT. They hold a License No. PT010453 (GA). The NPI Number for JONATHAN EVANS (DPT) is 1033493622

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN EVANS (DPT)
NPI
1033493622
Phone
(260) 570-8239
Address
11170 RILLITO LN
Enumeration Date
1 October 2011
Last Update Date
25 June 2020

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2607390300
Graduation Year
2011 (15 years ago)
PAC ID
4284952391
Group Practice PAC ID
4385962497
Professional Enrollment ID
I20150421000673

Contacts

Secure Messaging
info@protailored.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:14State licenses:2Other namesUpdated within 12 months

Provider Addresses for JONATHAN EVANS (DPT)

  • 11170 RILLITO LN

    301

    FORT WAYNE, IN 468452079

    Phone: (260) 570-8239

    Type: Mailing

  • 12722 TONKEL RD STE 102

    FORT WAYNE, IN 468458201

    Phone: (260) 739-0300

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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: 2015-04-21

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
I20150421000673IPhysical Therapist In Private PracticeINTBD

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 46845)

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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: 4385962497View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeIN
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeIN

Reviews

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Frequently asked questions

What is the 10-digit NPI for JONATHAN EVANS (DPT)?
JONATHAN EVANS (DPT) — NPI 1033493622 — is the standard way to identify this listing.
Is JONATHAN EVANS (DPT) listed as active for patients and plans?
The listing shows JONATHAN EVANS (DPT) as active in the NPI system.
What taxonomy line describes JONATHAN EVANS (DPT)?
For research purposes, treat JONATHAN EVANS (DPT) as Orthopedic Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does JONATHAN EVANS (DPT) list a practice location?
Patients near Fort Wayne, Indiana may find JONATHAN EVANS (DPT) in results; validate coverage separately.
Is the information about JONATHAN EVANS (DPT) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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