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EVAN CHARLES DEFALCO DO
NPI 1366184590
Family Medicine in Monongahela, PA

Active since April 08, 2022PECOS EnrolledAccepts Medicare Assignment
447 W MAIN ST, MONONGAHELA, PA 15063(724) 258-2070(724) 258-3582 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 5, 2022, Apr 8, 2022 (2 updates tracked since 2022).

About Evan Charles Defalco Do NPPES

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

EVAN CHARLES DEFALCO DO (NPI 1366184590) is an individual family medicine provider in Monongahela, Pennsylvania, licensed in Pennsylvania (OS024993) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with Penn Highlands Mon Valley, and is a graduate of Philadelphia College Of Osteopathic Medicine (2022).

NPPES Registry Identity

NPI1366184590
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameEVAN CHARLES DEFALCOCredential: DO
Location Address447 W MAIN STMonongahela, PA 15063-2564
Mailing Address100 Hospital AveDu Bois, PA 15801-1440 · (814) 375-2200 · Fax (814) 375-2484
Phone(724) 258-2070
Fax(724) 258-3582
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2022
Enumeration DateApril 8, 2022
Last NPPES UpdateOctober 28, 20252 updates tracked since enumeration
NPPES CertifiedOctober 28, 2025
✔ NPI 1366184590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · OS024993
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
447 W MAIN ST, Monongahela, PA 15063
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware 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 and accepts Medicare assignment

Evan Charles Defalco Do 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.

PECOS PAC ID345619813
PECOS Enrollment IDI20251215000258
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 Reassignments

2

Medicare enrollment records show Evan Defalco reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Monongahela Valley Hospital, Inc.
Same address
Family Medicine
447 W MAIN ST
Monongahela, PA 15063
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 9 clinicians in this Medicare group
NPI 1235085804 (724) 258-2070
Mon-Vale Primary Care Practices Inc
6.3 mi
Family Medicine
800 PLAZA DR STE 290
Rostraver Township, PA 15012
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 17 clinicians in this Medicare group
NPI 1669715843 (724) 379-6850

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

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Penn Highlands Mon Valley

Acute Care Hospitals · Monongahela, PA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390147
Location1163 Country Club RoadMonongahela, PA 15063 · Washington County
Emergency services

Jefferson Hospital

Acute Care Hospitals · Jefferson Hills, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390265
Location565 Coal Valley RoadJefferson Hills, PA 15025 · Allegheny County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15063 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONONGAHELA VALLEY HOSPITAL, INC.
Family Medicine
447 W MAIN ST
MONONGAHELA, PA 15063
Washington County (724) 258-2070
MRS. HOLLY MARIE DAWSON CRNP
Nurse Practitioner (Primary Care)
447 W MAIN ST
MONONGAHELA, PA 15063
Washington County (724) 258-2070
JOHN ALAN HOLETS M.D.
Family Medicine
447 W MAIN ST
MONONGAHELA, PA 15063
Washington County (724) 258-2070
PAMELA DALE MYERS NP
Nurse Practitioner (Family)
447 W MAIN ST
MONONGAHELA, PA 15063
Washington County (724) 258-2070
JOHN CHARLES EISLEY D.O.
Family Medicine
447 W MAIN ST
MONONGAHELA, PA 15063
Washington County (724) 258-2070
MONVIEW FAMILY MEDICAL CENTER, P.C.
Family Medicine
447 W MAIN ST
MONONGAHELA, PA 15063
Washington County (724) 258-2070
VICTORIA GERGELY CRNP
Family Medicine
447 W MAIN ST
MONONGAHELA, PA 15063
Washington County (724) 258-2070

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 Defalco's NPI number?

The NPI number for Evan Defalco is 1366184590. It was assigned to this individual provider in the NPPES registry on April 8, 2022.

Where is Evan Defalco located?

Evan Defalco practices at 447 W Main St, Monongahela, PA 15063. The listed phone number is (724) 258-2070.

What is Evan Defalco's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Evan Defalco enrolled in Medicare?

Yes. Evan Defalco 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 organizations bill Medicare for Evan Defalco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Evan Defalco reassigns Medicare benefits to 2 organizations: Monongahela Valley Hospital, Inc. (Monongahela, PA) and Mon-Vale Primary Care Practices Inc (Rostraver Township, PA). Each 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 Defalco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Evan Defalco accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan and Highmark Blue Cross Blue Shield West Virginia list Evan Defalco 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.

Is Evan Defalco affiliated with any hospitals?

According to CMS data, Evan Defalco is affiliated with Penn Highlands Mon Valley and Jefferson Hospital.

When was this NPI record last updated?

The NPPES record for Evan Defalco was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.