EVOLUTION HEALTHCARE MANAGEMENT LLC
NPI 1770951980
Clinic/Center - Primary Care in Mesa, AZ
About Evolution Healthcare Management Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVOLUTION HEALTHCARE MANAGEMENT LLC (NPI 1770951980), doing business as Evolution Management Services Company, is a healthcare organization registered as a primary care in Mesa, Arizona and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through February 20, 2028, maintains a secondary practice location in Apache Junction, and lists Fawn Michelle Boonstra, President, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Evolution Healthcare Management Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Evolution Healthcare Management LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 03D2179363
Evolution Healthcare Management LLC · Mesa, AZFrequently 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 Evolution Healthcare Management LLC's NPI number?
The NPI number for Evolution Healthcare Management LLC is 1770951980. It was assigned to this organization in the NPPES registry on September 3, 2015. The provider was formerly known as Evolution Management Services Company.
Where is Evolution Healthcare Management LLC located?
Evolution Healthcare Management LLC is located at 7615 E Baseline Rd Suite 101, Mesa, AZ 85209. The listed phone number is (480) 354-7878.
What is Evolution Healthcare Management LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Evolution Healthcare Management LLC enrolled in Medicare?
Yes. Evolution Healthcare Management LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Evolution Healthcare Management LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Evolution Healthcare Management LLC. A 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 the clinician's services. The largest specialties are Nurse Practitioner (3) and Cardiovascular Disease (Cardiology) (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Evolution Healthcare Management LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2179363) is associated with this NPI, valid through February 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Evolution Healthcare Management LLC was last updated on September 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Evolution Healthcare Management Llc · NPI 1770951980
Primary Care organization in Mesa, Arizona. Organization record, active in the CMS NPPES registry since September 3, 2015.
## Identity
- **NPI:** 1770951980 (Entity type: Organization)
- **Enumerated:** September 3, 2015
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Also known as:** EVOLUTION MANAGEMENT SERVICES COMPANY (Former Legal Business Name)
- **Organization subpart:** No
- **Authorized official:** Fawn Boonstra, PRESIDENT, MANAGER
## Practice location
- **Address:** 7615 E BASELINE RD, SUITE 101, Mesa, AZ 85209-8520
- **Phone:** (480) 354-7878
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Cardiovascular Disease (Cardiology) (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 12, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1770951980) · Data from the CMS NPPES public registry.