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

Mr. Jed Edison Mance Evangelista, PT

Individual provider Physical Therapist · NPI 1215592845

Mr. Jed Edison Mance Evangelista, PT is a Physical Therapist in Private Practice in Kew Gardens, New York. Qualified in 2011, 15 years ago. Registered with an NPI since 2019.

Years since qualifying
15
In the registry since
2019
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

8532 125th St
Kew Gardens, NY 11415-3311
Phone: (410) 629-9872
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1215592845
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 9, 2019
Last updated in NPPESMay 9, 2019

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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