ETHAN EVANKOW PA
NPI 1528580966
Physician Assistant - Medical in Dover Foxcroft, ME

Q: What is Ethan Evankow's NPI number?

The NPI number for Ethan Evankow is 1528580966. It was assigned to this individual provider in the NPPES registry on July 7, 2017.

Q: What is Ethan Evankow's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Evankow was last updated on July 22, 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.

Active since July 07, 2017PECOS Enrolled

897 W MAIN ST, DOVER FOXCROFT, ME 04426(207) 564-8401 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 10, 2025, Dec 2, 2021, Feb 1, 2021 and 2 more (5 updates tracked since 2017).

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About Ethan Evankow Pa NPPES

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

ETHAN EVANKOW PA (NPI 1528580966) is an individual medical provider in Dover Foxcroft, Maine, licensed in Maine (PA1241) and active in the NPI registry since July 2017. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1528580966

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameETHAN EVANKOWCredential: PA

Location Address897 W MAIN STDover Foxcroft, ME 04426-1029

Mailing AddressPo Box 639601Cincinnati, OH 45263-9601 · (856) 686-4393 · Fax (856) 694-5179

Phone(207) 564-8401

Sole ProprietorNo

Enumeration DateJuly 7, 2017

Last NPPES UpdateJuly 22, 20255 updates tracked since enumeration

NPPES CertifiedJuly 22, 2025

✔ NPI 1528580966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in ME · PA1241

Also ListedPhysician AssistantTaxonomy 363A00000X · License 055.0031348 (VT), PA1241 (ME)

897 W MAIN ST, Dover Foxcroft, ME 04426

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Secondary Practice Locations 2

Location 1791 Turner St Unit 2Auburn, ME 04210-6314 · Phone (207) 330-3900 · Fax (207) 330-3940

Location 2100 Hospital DrBennington, VT 05201-5004 · Phone (802) 447-5023

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Evankow Pa 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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

91 services84 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

61 services59 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

16 services16 patients

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.

MR. WILLIAM STEPHEN SHEPPARD PA-C

Physician Assistant