EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE
NPI 1942710256
Clinic/Center - Primary Care in Arlington, TX
About Evergreen Testosterone Clinic & Primary Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE (NPI 1942710256) is a healthcare organization registered as a primary care in Arlington, Texas and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through October 29, 2027 and lists Ken Wamwiri, President And Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 Testosterone Clinic & Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Evergreen Testosterone Clinic & Primary Care, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 45D2139078
Evergreen Testosterone Clinic & Primary Care · Arlington, TXFrequently 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 Testosterone Clinic & Primary Care's NPI number?
The NPI number for Evergreen Testosterone Clinic & Primary Care is 1942710256. It was assigned to this organization in the NPPES registry on October 2, 2017.
Where is Evergreen Testosterone Clinic & Primary Care located?
Evergreen Testosterone Clinic & Primary Care is located at 623 Matlock Centre Cir, Arlington, TX 76015. The listed phone number is (214) 870-0885.
What is Evergreen Testosterone Clinic & Primary Care's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Evergreen Testosterone Clinic & Primary Care enrolled in Medicare?
Yes. Evergreen Testosterone Clinic & Primary Care is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Evergreen Testosterone Clinic & Primary Care?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Evergreen Testosterone Clinic & Primary Care. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Evergreen Testosterone Clinic & Primary Care hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2139078) is associated with this NPI, valid through October 29, 2027. 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 Testosterone Clinic & Primary Care was last updated on July 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Evergreen Testosterone Clinic & Primary Care · NPI 1942710256
Primary Care organization in Arlington, Texas. Organization record, active in the CMS NPPES registry since October 2, 2017.
## Identity
- **NPI:** 1942710256 (Entity type: Organization)
- **Enumerated:** October 2, 2017
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Ken Wamwiri, PRESIDENT AND CEO
## Practice location
- **Address:** 623 MATLOCK CENTRE CIR, Arlington, TX 76015-2535
- **Phone:** (214) 870-0885
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 14, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1942710256) · Data from the CMS NPPES public registry.