EVERGREEN FAMILY MEDICAL SERVICES,P.C.
NPI 1891761243
Family Medicine in Brooklyn, NY
About Evergreen Family Medical Services,p.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVERGREEN FAMILY MEDICAL SERVICES,P.C. (NPI 1891761243) is a healthcare organization registered as a family medicine in Brooklyn, New York and active in the NPI registry since February 2006. The organization holds a CLIA Waiver certificate valid through May 22, 2028 and lists Raymond Chan, Medical Diretor, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 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)
Evergreen Family Medical Services,p.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Evergreen Family Medical Services,p.C., which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
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 33D1054483
Evergreen Family Medical Services PC · Brooklyn, NYFrequently 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 Evergreen Family Medical Services,p.C.'s NPI number?
The NPI number for Evergreen Family Medical Services,p.C. is 1891761243. It was assigned to this organization in the NPPES registry on February 26, 2006.
Where is Evergreen Family Medical Services,p.C. located?
Evergreen Family Medical Services,p.C. is located at 743 58th St, Brooklyn, NY 11220. The listed phone number is (718) 765-0088.
What is Evergreen Family Medical Services,p.C.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Evergreen Family Medical Services,p.C. enrolled in Medicare?
Yes. Evergreen Family Medical Services,p.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Evergreen Family Medical Services,p.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Evergreen Family Medical Services,p.C.. 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 Internal Medicine (3) and Family Practice (2). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Evergreen Family Medical Services,p.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D1054483) is associated with this NPI, valid through May 22, 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 Evergreen Family Medical Services,p.C. was last updated on October 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Evergreen Family Medical Services,p.c. · NPI 1891761243
Family Medicine organization in Brooklyn, New York. Organization record, active in the CMS NPPES registry since February 26, 2006.
## Identity
- **NPI:** 1891761243 (Entity type: Organization)
- **Enumerated:** February 26, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Raymond Chan, MEDICAL DIRETOR
## Practice location
- **Address:** 743 58TH ST, Brooklyn, NY 11220-3916
- **Phone:** (718) 765-0088 · **Fax:** (718) 567-8208
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (3), Family Practice (2); 2 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 1, 2012
- **Other identifiers:** Medicaid 02720354 (NY); Medicare ID-Type Unspecified 3334P1 (NY); Medicare UPIN I48504
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1891761243) · Data from the CMS NPPES public registry.