Evan Los, EVAN LOS, MD in Johnson City, TN

Evan Los, EVAN LOS, MD is a medicare enrolled "Pediatrics - Pediatric Endocrinology" physician in Johnson City, Tennessee. His current practice location is 408 N State Of Franklin Rd, Suite 31b, Johnson City, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 431-4946.

Evan Los is licensed to practice in Tennessee (license number 54336) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1174842348.

Contact Information

	Evan Los, EVAN LOS, MD
	408 N State Of Franklin Rd, Suite 31b, Johnson City, TN 37604-6089
	(423) 431-4946
	(423) 431-4947

Map and Direction

Physician's Profile

Full Name	Evan Los
Gender	Male
Speciality	Pediatrics - Pediatric Endocrinology
Location	408 N State Of Franklin Rd, Johnson City, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174842348
Provider Enumeration Date: 05/26/2010
Last Update Date: 02/15/2017

Medicare PECOS Information:

PECOS PAC ID: 1052566866
Enrollment ID: I20160801001045

Medical Identifiers

Medical identifiers for Evan Los such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174842348	NPI	-	NPPES
1174842348	Medicaid	VA
Q022585	Medicaid	TN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	54336 (Tennessee)	Secondary
2080P0205X	Pediatrics - Pediatric Endocrinology	54336 (Tennessee)	Primary
208000000X	Pediatrics	MD163055 (Oregon)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Evan Los allows following entities to bill medicare on his behalf.

Entity Name	Blue Ridge Medical Management Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144380833 PECOS PAC ID: 9739099441 Enrollment ID: O20031204000996

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evan Los is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Evan Los, EVAN LOS, MD 408 N State Of Franklin Rd, Suite 31b, Johnson City, TN 37604-6089 Ph: (423) 431-4946	Evan Los, EVAN LOS, MD 408 N State Of Franklin Rd, Suite 31b, Johnson City, TN 37604-6089 Ph: (423) 431-4946

Reviews and Comments

Pediatrics Doctors in Johnson City, TN

John William Schweitzer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604 Phone: 423-439-7320
Mrs. Priya Narayanan Jain, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 325 N. State Of Franklin Road, Ground Fl, Johnson City, TN 37604 Phone: 423-439-7320
Jodi B Gage, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 325 N. State Of Franklin Road, Ground Floor, Johnson City, TN 37604 Phone: 423-439-7320 Fax: 423-439-7343
Dr. Demetrio Rebano Macariola Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604 Phone: 423-439-7320 Fax: 423-439-7343
Karen E Schetzina, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604 Phone: 423-439-7320 Fax: 423-439-7343
William Scott Dodd, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604 Phone: 423-439-7320 Fax: 423-439-7343
Ahmad A Wattad, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604 Phone: 423-439-7320 Fax: 423-439-7343

Evan Los, EVAN LOS, MD - Medicare Pediatrics in Johnson City, TN