DR. ANDREW EVANS D.O.
NPI 1104202969
Student in an Organized Health Care Education/Training Program in Wellington, FL
About Dr. Andrew Evans D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ANDREW EVANS D.O. (NPI 1104202969) is an individual student in an organized health care education/training program in Wellington, Florida, licensed in Florida (UO4688) and active in the NPI registry since August 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Andrew Evans D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Andrew Evans reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92120
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WELLINGTON, FL 33414
WELLINGTON, FL 33414
WELLINGTON, FL 33414
WELLINGTON, FL 33414
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andrew Evans's NPI number?
The NPI number for Andrew Evans is 1104202969. It was assigned to this individual provider in the NPPES registry on August 4, 2015.
Where is Andrew Evans located?
Andrew Evans practices at 10101 Forest Hill Blvd Medical Education, Wellington, FL 33414. The listed phone number is (561) 798-8504.
What is Andrew Evans's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Andrew Evans enrolled in Medicare?
Yes. Andrew Evans is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Andrew Evans's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Evans reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Evans's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Andrew Evans was last updated on November 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Andrew Evans, D.O. · NPI 1104202969
Student in an Organized Health Care Education/Training Program provider in Wellington, Florida. Individual provider, active in the CMS NPPES registry since August 4, 2015.
## Identity
- **NPI:** 1104202969 (Entity type: Individual)
- **Enumerated:** August 4, 2015
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** UO4688 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 10101 FOREST HILL BLVD, MEDICAL EDUCATION, Wellington, FL 33414-6103
- **Phone:** (561) 798-8504
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1225060742, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** November 3, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1104202969) · Data from the CMS NPPES public registry.