Active NPI
Evan Plys, PHD
- Clinical Psychologist
- Boston, MA
National Provider Identifier
1033731609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY.0005276
- Practice address
- 55 Fruit St
Boston, MA 02114-2696 - Phone
- (617) 724-5600
- NPI assigned
- May 17, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | |||
| Clinical Psychologist | 103TC0700X | PSY.0005276 | CO | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2696
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | NA | Massachusetts General Physicians Organization Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0005276 | CO | MD | Clinical Psychologist |
| 11823 | MA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts General Physicians Organization Inc | Current | Accepting new patients | |
| General Hospital Corp | Current | Accepting new patients | |
| The General Hospital Corporation | Current | Accepting new patients |
Locations
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
55 Fruit St
Boston, MA 02114
Interoperability endpoints
- plys.evan.mgh@direct.partners.masshiway.net
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1033731609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110429",
"city": "AURORA",
"state": "CO",
"postal_code": "800420429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142696",
"telephone_number": "617-724-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLYS",
"first_name": "EVAN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-17",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY.0005276",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "Y",
"affiliationName": "Massachusetts General Physicians Organization Inc",
"address_1": "55 Fruit St",
"city": "Boston",
"state": "MA",
"country_code": "US",
"postal_code": "021142696",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.