Evernorth Medical Care Providers New York Professional Corporation - Medicare Primary Care in Melville, NY

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Evernorth Medical Care Providers New York Professional Corporation is a medicare enrolled primary clinic (Family Medicine) in Melville, New York. The current practice location for Evernorth Medical Care Providers New York Professional Corporation is 555 Broadhollow Rd Ste 305, Melville, New York. For appointments, you can reach them via phone at (773) 292-4800. The mailing address for Evernorth Medical Care Providers New York Professional Corporation is 730 Cool Springs Blvd Ste 500, Franklin, Tennessee and phone number is (773) 292-4800.

Evernorth Medical Care Providers New York Professional Corporation is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1205234291. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (773) 292-4800.

Contact Information

Evernorth Medical Care Providers New York Professional Corporation
555 Broadhollow Rd Ste 305
Melville
NY 11747-5018
(773) 292-4800
(312) 564-4059

Map and Direction


Primary Care Clinic Profile

Full NameEvernorth Medical Care Providers New York Professional Corporation
SpecialityFamily Medicine
Location555 Broadhollow Rd Ste 305, Melville, New York
Authorized Official Name and PositionGrace Blue (CREDENTIALING SR. MANAGER)
Authorized Official Contact7732924800
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Evernorth Medical Care Providers New York Professional Corporation
730 Cool Springs Blvd Ste 500
Franklin
TN 37067-7331

Ph: (773) 292-4800		Evernorth Medical Care Providers New York Professional Corporation
555 Broadhollow Rd Ste 305
Melville
NY 11747-5018

Ph: (773) 292-4800

NPI Details:

NPI Number1205234291
Provider Enumeration Date12/08/2014
Last Update Date02/13/2024

Medicare PECOS Information:

Medicare PECOS PAC ID2365813904
Medicare Enrollment IDO20230119000427

Medical Identifiers

Medical identifiers for Evernorth Medical Care Providers New York Professional Corporation such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205234291NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary
207QA0505XFamily Medicine - Adult Medicine (* (Not Available))Secondary
207QH0002XFamily Medicine - Hospice And Palliative Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Secondary
207RH0002XInternal Medicine - Hospice And Palliative Medicine (* (Not Available))Secondary
213E00000XPodiatrist (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Evernorth Medical Care Providers New York Professional Corporation acts as a billing entity for following providers:
Provider NameLorane Harris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285894857
PECOS PAC ID: 3779658877
Enrollment ID: I20080825000650
Provider NameDonna M Pangilinan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578818928
PECOS PAC ID: 2769631969
Enrollment ID: I20121003000566
Provider NameLindon Richards
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467957407
PECOS PAC ID: 0042573354
Enrollment ID: I20180420000083
Provider NameYelisa Jimenez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891339867
PECOS PAC ID: 2860821816
Enrollment ID: I20200326002761
Provider NameAbdul-razak Mohammed
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346668712
PECOS PAC ID: 9638410582
Enrollment ID: I20210817000530
Provider NameFelisha Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689012221
PECOS PAC ID: 2264826023
Enrollment ID: I20220222001357
Provider NameShannon Alsop
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003043803
PECOS PAC ID: 7517121742
Enrollment ID: I20230119000585
Provider NameJahnin Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679865737
PECOS PAC ID: 3779937461
Enrollment ID: I20230928003563
Provider NameJoan Ferrelli
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114955424
PECOS PAC ID: 1355521337
Enrollment ID: I20231106002224
Provider NameTanisha P. Henry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629610167
PECOS PAC ID: 9537502265
Enrollment ID: I20240208003902
Provider NameMelissa R Dezan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346609773
PECOS PAC ID: 5991142549
Enrollment ID: I20240319002493

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.