Maristella S Evangelista · Plastic and Reconstructive Surgery Physician

2799 W Grand Blvd, Detroit, MI 48202-2608

Overview

Maristella S Evangelista is a Plastic and Reconstructive Surgery Physician practicing in Detroit, Michigan. The National Provider Identifier (NPI) is #1962720821, which was assigned on May 17, 2010, and the registration record was last updated on June 30, 2025. The practitioner's main practice location is at 2799 W Grand Blvd, Detroit, MI 48202-2608; the contact telephone number is 3139162378. The primary taxonomy of Maristella S Evangelista is Plastic and Reconstructive Surgery Physician (2086S0122X), with specialization in Plastic and Reconstructive Surgery. Maristella S Evangelista is licensed to practice in the state of Ohio (#35127325), Michigan (#4301116571).

A surgeon who specializes in plastic and reconstructive surgery.

Provider Information

NPI 1962720821
Entity Type Individual
Provider Name DR. MARISTELLA S EVANGELISTA
Gender Female
Credential MD
Practice Address 2799 W Grand Blvd
Detroit
MI 48202-2608
Practice Telephone 3139162378
Mailing Address 1293 Southfield Rd
Birmingham
MI 48009-3081
Mailing Telephone 7349457295
Certification Date 2025-06-30
Enumeration Date 2010-05-17
Last Update Date 2025-06-30
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 0648497040
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name MARISTELLA S EVANGELISTA
Medical School TUFTS UNIVERSITY SCHOOL OF MEDICINE
Primary Specialty PLASTIC AND RECONSTRUCTIVE SURGERY
Organization Legal Name HENRY FORD HEALTH SYSTEM
Address 2799 W Grand Blvd
Detroit
MI 48202-2608

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N208200000XPlastic Surgery35127325OH
Y2086S0122XSurgeryPlastic and Reconstructive Surgery4301116571MI

Taxonomy Information

Primary Taxonomy

Code 2086S0122X
Taxonomy Plastic and Reconstructive Surgery Physician
Classification Surgery
Specialization Plastic and Reconstructive Surgery
Grouping Allopathic & Osteopathic Physicians
Definition: A surgeon who specializes in plastic and reconstructive surgery.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery.

Other Taxonomy

Code 208200000X
Taxonomy Plastic Surgery Physician
Classification Plastic Surgery
Grouping Allopathic & Osteopathic Physicians
Definition: A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Abraham Pathak, Md PLLC 3020 Westchester Ave Ste 306, Purchase, NY 10577-2525Plastic and Reconstructive Surgery Physician2025-10-13
Synergy Global Health Inc. 9070 E Desert Cove Ave # A102, Scottsdale, AZ 85260-6227Plastic and Reconstructive Surgery Physician2025-06-17
Body and Face Plastic Surgery 1030 N Flowood Dr Ste A, Flowood, MS 39232-9532Plastic and Reconstructive Surgery Physician2025-08-27
Baily Bellamy 4510 Nw 6th Pl, Gainesville, FL 32607-6111Plastic and Reconstructive Surgery Physician2025-09-20
Poudre Valley Medical Group, LLC 3843 Rio Vista Dr Ste 2700, Colorado Springs, CO 80917-3379Plastic and Reconstructive Surgery Physician2025-07-09
Peripheral Nerve Surgery PC 570 Sylvan Ave Fl 2, Englewood Cliffs, NJ 07632-3132Plastic and Reconstructive Surgery Physician2025-10-21
Elite Wound Care Md, LLC 2023 N Mason Rd Ste 203, Katy, TX 77449-3779Plastic and Reconstructive Surgery Physician2025-06-20
Cps Partners LLC 5550 Friendship Blvd Ste 130, Chevy Chase, MD 20815-7201Plastic and Reconstructive Surgery Physician2025-09-30
Synergyhealth360 PLLC 9070 E Desert Cove Ave Ste 106, Scottsdale, AZ 85260-6228Plastic and Reconstructive Surgery Physician2025-06-30
Alexander Chase Castillo 6316 N 10th St, Mcallen, TX 78504-3599Plastic and Reconstructive Surgery Physician2025-08-20
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Location Information

Street Address 2799 W GRAND BLVD
City DETROIT
State MI
Zip Code 48202-2608
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Rhiannon Marie-Heckel Boguszewicz 2799 W Grand Blvd, Detroit, MI 48202-2608Nurse Practitioner2025-09-30
Anthony Yazbeck 2799 W Grand Blvd, Detroit, MI 48202-2608Student in an Organized Health Care Education/Training Program2025-06-24
Kristen Morrison 2799 W Grand Blvd, Detroit, MI 48202-2608Occupational Therapist2025-10-02
Joman Haffar 2799 W Grand Blvd, Detroit, MI 48202-2608Student in an Organized Health Care Education/Training Program2025-07-28
Sandra Ghaly 2799 W Grand Blvd, Detroit, MI 48202-2608Pharmacist2025-06-19
Promise Bomide 2799 W Grand Blvd, Detroit, MI 48202-2608Student in an Organized Health Care Education/Training Program2025-07-03
Ali Saad Rizk 2799 W Grand Blvd, Detroit, MI 48202-2608Anatomic Pathology & Clinical Pathology Physician2025-08-21
Xiaolan Fang 2799 W Grand Blvd, Detroit, MI 48202-2608Clinical Cytogenetics Physician2025-09-10
Nicole Diane Langley 2799 W Grand Blvd, Detroit, MI 48202-2608Certified Registered Nurse Anesthetist2025-08-25
Mikyla Loryl Reesor 2799 W Grand Blvd, Detroit, MI 48202Student in an Organized Health Care Education/Training Program2025-06-17
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Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Eleanor M. Walker Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202-2608Radiation Oncology Physician2006-12-08
Sheela Tejwani Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202-2608Internal Medicine Physician2006-12-01
Robert A. Chapman Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202-2608Internal Medicine Physician2006-12-01
Rohit Shenoy Ranjal 2799 W. Grand Boulevard, Henry Ford Hospital, Medical Education Department, Detroit, MI 48202-2608Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician2017-04-10
David W. Hudgel Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202-2608Internal Medicine Physician2006-12-01
Joshua Tear Gaudette 2799 W. Grand Boulevard, Henry Ford Hospital, Medical Education Department, Detroit, MI 48202-2608Diagnostic Radiology Physician2020-04-03

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Belinda Busogi 3031 W Grand Blvd, Suite 600, Detroit, MI 48202Student in an Organized Health Care Education/Training Program2025-05-20
Andrea G Ciaravino Herny Ford, 2799 West Grand Blvd, Detroit, MI 48202Physician Assistant2008-10-10
Robinetta Elizabeth Armstrong · Robinetta Elizabeth Burgan 2799 West Grand Blvd., Detroit, MI 48202Acute Care Nurse Practitioner2013-07-10
Katie Burlen-Davis 9045 Woodward Ave, Detroit, MI 48202Family Nurse Practitioner2020-01-03
Rita R. Clark 7375 Woodward, Suite 1010, Detroit, MI 48202Social Worker2013-12-20
Tony Awad · Anton Awad 1 Ford Pl Ste 2e, Detroit, MI 48202Anesthesiology Physician2006-07-24
Jorge A. Gutierrez Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202Neuropathology Physician2007-01-08
Melissa Leigh Miller · Melissa Leigh Suchon Henry Ford Hospital Cancer - 2800 W Grand Blvd, Detroit, MI 48202Nurse Practitioner2014-06-20
Lisa Hill 80 Webb Street, Detroit, MI 48202Case Manager/Care Coordinator2025-03-11
John L. Carey Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202Immunopathology Physician2007-01-08
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Similar Providers

Providers with similar names

Provider NameAddressTaxonomyEnumeration Date
Charlene Evangelista 4733 Chabot Dr Ste 203, Pleasanton, CA 94588-3972Occupational Therapist2025-10-24
Tiara Evangelista 612 E Boulevard, Kokomo, IN 46902-2271Behavior Technician2025-03-11
Tia Araceli Evangelista 206 Bergen Ave, Kearny, NJ 07032-3384Physical Therapist2025-08-29
Shelby Nicole Weeden Evangelista · Shelby Weeden Evangelista 4629 Church St, Milton, FL 32583-4107Behavior Technician2022-04-17
Amy Elizabeth Evangelista 31098 Oakleaf Ln, Franklin, MI 48025-1262Speech-Language Pathologist2025-06-28
Judi Evangelista 12912 Brookhurst St Ste 480, Garden Grove, CA 92840-4867Marriage & Family Therapist2021-12-28
Patrick Evangelista 26895 Sw Mcleod St, Wilsonville, OR 97070-6815Family Nurse Practitioner2025-08-11
Abigail A Evangelista 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806Student in an Organized Health Care Education/Training Program2022-04-30
Deb Evangelista 1700 Gaucho Ct, Longmont, CO 80504-8211Doula2025-04-17
Zachary Payton Evangelista 923 N Milpas St, Santa Barbara, CA 93103-2331Student in an Organized Health Care Education/Training Program2025-04-25

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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.