Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael Evangelist, MSPT

Individual provider Physical Therapist · NPI 1780735316

Michael Evangelist, MSPT is a Physical Therapist in Private Practice in West Orange, New Jersey. Qualified in 2004, 22 years ago. Practices with Jag-One Physical Therapy LLC, a 328-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
22
Licensed in
NJ
In the registry since
2007
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Practice location Address checks out

622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone: (973) 669-0078
Fax: (973) 669-1113
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA01129500 (NJ)

Record details

NPI number1780735316
Entity typeIndividual (Type 1)
GenderMale
Credentials MSPT
Sole proprietorNo
NPI enumeratedJanuary 12, 2007
Last updated in NPPESJuly 8, 2007
Mailing address715 Clinton St, Apt 17, Hoboken, NJ 07030-2841

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Jag-One Physical Therapy Llc — 328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in West Orange