EVAN DECAN (MD) – Surgical Critical Care Physician, NPI 1609335421

EVAN DECAN (MD) is a healthcare provider. based in Charlottesville, Virginia. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. 0101286616 (VA). The NPI Number for EVAN DECAN (MD) is 1609335421

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
EVAN DECAN (MD)
NPI
1609335421
Phone
(434) 924-3627
Address
1215 Lee St
Enumeration Date
19 March 2019
Last Update Date
15 September 2025

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
4349245125
Graduation Year
2019 (7 years ago)
PAC ID
0143611236
Group Practice PAC ID
4880590728
Professional Enrollment ID
I20250804001424
Address ID
VA229033363CH1300XAVEX402

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness95
Years active:7State licenses:1Other names

935 GENERAL SURGERY in VA

Provider Addresses for EVAN DECAN (MD)

  • 1215 Lee St

    Charlottesville, VA 229080816

    Phone: (434) 924-3627

    Type: Location

  • West Sunset Boulevard, Little Armenia, East Hollywood, Los Angeles, Los Angeles County, California, 90029-2631, United States

    LOS ANGELES, CA 900276021

    Phone:

    Type: Mailing

  • PO BOX 749112

    ATLANTA, GA 303749112

    Phone: (434) 295-1000

    Type: Mailing

  • 1300 JEFFERSON PARK AVE

    CHARLOTTESVILLE, VA 229033363

    Phone: (434) 282-1742

    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: 2025-08-04

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
I20250804001424IGeneral SurgeryVATBD

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 22908)

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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: 4880590728View full group profile

Reviews

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Frequently asked questions

What identifier follows EVAN DECAN (MD) across health systems?
The NPI 1609335421 uniquely identifies EVAN DECAN (MD) in U.S. healthcare data.
Is EVAN DECAN (MD)'s NPI status active today?
Active status means EVAN DECAN (MD)'s NPI record is not deactivated in the public file.
What services align with EVAN DECAN (MD)'s listing?
EVAN DECAN (MD)'s public classification highlights Surgical Critical Care Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to EVAN DECAN (MD)?
EVAN DECAN (MD) is associated with Charlottesville, Virginia in the same public data insurers reference.
Who maintains EVAN DECAN (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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