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EVAN ANDREW LOS EVAN LOS, M.D.
NPI 1174842348
Pediatrics - Pediatric Endocrinology in Johnson City, TN

Active since May 26, 2010PECOS Enrolled
408 N STATE OF FRANKLIN RD, SUITE 31B, JOHNSON CITY, TN 37604(423) 431-4946(423) 431-4947 Get Directions Write a Review

NPPES record last updated: March 3, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 3, 2025, Feb 15, 2017 (2 updates tracked since 2017).

About Evan Andrew Los Evan Los, M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVAN ANDREW LOS EVAN LOS, M.D. (NPI 1174842348) is an individual pediatric endocrinology provider in Johnson City, Tennessee, licensed in Tennessee (54336) and active in the NPI registry since May 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174842348
Entity TypeIndividualMale
Primary Taxonomy2080P0205X
Provider Legal NameEVAN ANDREW LOSCredential: EVAN LOS, M.D.
Location Address408 N STATE OF FRANKLIN RD, SUITE 31BJohnson City, TN 37604-6089
Mailing Address408 N State Of Franklin Rd, Suite 31bJohnson City, TN 37604-6089 · (423) 431-4946 · Fax (423) 431-4947
Phone(423) 431-4946
Fax(423) 431-4947
Sole ProprietorNo
Enumeration DateMay 26, 2010
Last NPPES UpdateMarch 3, 20252 updates tracked since enumeration
NPPES CertifiedMarch 3, 2025
✔ NPI 1174842348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric EndocrinologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0205X
License✔ Licensed in TN · 54336
Definition
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.
Also ListedPediatricsTaxonomy 208000000X · License 54336 (TN), MD163055 (OR)
408 N STATE OF FRANKLIN RD, Johnson City, TN 37604
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Other Identifiers 2

Medicaid1174842348VA
MedicaidQ022585TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evan Andrew Los Evan Los, M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Evan Los reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Blue Ridge Medical Management Corporation
Same address
Neurological Surgery
408 N STATE OF FRANKLIN RD, SUITE 42
Johnson City, TN 37604
  • Reassigned Medicare billing, Tennessee enrollment
  • 496 clinicians in this Medicare group
NPI 1073555934 (423) 431-2350

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. PAULA RENEE SMITH M.D.
Internal Medicine
408 N STATE OF FRANKLIN RD, SUITE 24
JOHNSON CITY, TN 37604
Washington County (423) 431-1810
MR. LARRY MICHAEL STEVENS II APN
Nurse Practitioner (Adult Health)
408 N STATE OF FRANKLIN RD, SUITE 24
JOHNSON CITY, TN 37604
Washington County (423) 431-1810
DR. SAMUEL WINSTON HUDDLESTON V M.D.
Radiology (Diagnostic Radiology)
408 N STATE OF FRANKLIN RD, SUITE 31
JOHNSON CITY, TN 37604
Washington County (423) 431-2478
ALEXIS HODGE DUTY FNP
Nurse Practitioner (Family)
408 N STATE OF FRANKLIN RD, SUITE 31B
JOHNSON CITY, TN 37604
Washington County (423) 431-4946
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Neurological Surgery
408 N STATE OF FRANKLIN RD, SUITE 42
JOHNSON CITY, TN 37604
Washington County (423) 431-2350
MRS. AMIE JARRETT BRIGGS FNP-BC
Nurse Practitioner
408 N STATE OF FRANKLIN RD, SUITE 31C
JOHNSON CITY, TN 37604
Washington County (423) 431-4946
DR. ANDREW S PIERCE MD
Internal Medicine
408 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-1810
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Internal Medicine (Gastroenterology)
408 N STATE OF FRANKLIN RD, SUITE 24
JOHNSON CITY, TN 37604
Washington County (423) 431-1810

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 Evan Los's NPI number?

The NPI number for Evan Los is 1174842348. It was assigned to this individual provider in the NPPES registry on May 26, 2010.

Where is Evan Los located?

Evan Los practices at 408 N State Of Franklin Rd Suite 31B, Johnson City, TN 37604. The listed phone number is (423) 431-4946.

What is Evan Los's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Endocrinology, with taxonomy code 2080P0205X.

Is Evan Los enrolled in Medicare?

Yes. Evan Los is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Evan Los's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Evan Los reassigns Medicare benefits to Blue Ridge Medical Management Corporation (Johnson City, TN). 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 Evan Los's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Evan Los accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 3 other insurers list Evan Los as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Evan Los was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.