EVAN DAVID EVANS (PA-C) – Physician Assistant, NPI 1013548056
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for EVAN DAVID EVANS (PA-C)
501 Gopher Dr
Tomah, WI 546604513
Phone: (608) 372-2181
Type: Location
Corner of Routes N12 & N7
Fort Defiance, AZ 86504
Phone: (928) 729-8000
Type: Location
77 E THOMAS RD STE 230
PHOENIX, AZ 850123100
Phone: (602) 222-1900
Fax: (602) 557-0002
Type: Mailing
1313 E OSBORN RD STE 150
PHOENIX, AZ 850145688
Phone: (602) 222-1900
Fax: (602) 266-3870
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: 2026-02-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20210402000403 | I | Physician Assistant | NY | TBD |
| I20221206000131 | I | Physician Assistant | MA | TBD |
| I20240918003246 | I | Physician Assistant | TN | TBD |
| I20260213000656 | I | Physician Assistant | GA | 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.
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 54660)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MD | |
| - | TN | |
| Diagnostic Radiology | NC | |
| Diagnostic Radiology | TN | |
| Diagnostic Radiology | TN | |
| Nurse Practitioner | TN | |
| Diagnostic Radiology | TN | |
| Diagnostic Radiology | TN | |
| Diagnostic Radiology | TN | |
| Nurse Practitioner | KY |
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