Active NPI
Robert James Evans, APRN
- Nurse Practitioner
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN210429
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 724-4500
- NPI assigned
- Aug 8, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN210429 | MA | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | 088716-23 | NH |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
789 Central Ave
Dover, NH 03820-2526
Phone (603) 609-6925
Other practice location 1
789 Central Ave
Dover, NH 03820-2526
Phone (603) 609-6925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3138060 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 McGregor St
Manchester, NH 03102-3730
Phone (603) 668-3545
789 Central Ave
Dover, NH 03820-2526
Phone (603) 609-6260
Hospital & facility affiliations
- Wentworth-Douglass Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN210429 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intensive Care Consortium Inc | Nurse Practitioner | Current | Accepting new patients |
| Catholic Medical Center | Current | Accepting new patients | |
| Catholic Medical Center | Current | Accepting new patients | |
| Wentworth Douglass Physician Corporation | Current | Accepting new patients | |
| Wentworth Douglass Physician Corporation | Current | Accepting new patients | |
| Wentworth Douglass Physician Corporation | Current | Accepting new patients | |
| Wentworth Douglass Hospital | Current | Accepting new patients |
Locations
789 Central Ave
#2
Dover, NH 03820
Phone (603) 740-2503
789 Central Ave
#1
Dover, NH 03820
Phone (603) 609-6260
789 Central Ave
Dover, NH 03820
Phone (603) 740-2832
100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931
333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
Interoperability endpoints
- evans.robert.wdh@direct.partners.masshiway.net
Organizations & group practices 7
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.
-
- Magnetic Resonance Imaging Radiologic Technologist
- Dover, NH
- NPI 1447352430
-
- General Acute Care Hospital
- Manchester, NH
- NPI 1427154335
-
- Anesthesiology Physician
- Manchester, NH
- NPI 1003692112
-
- General Acute Care Hospital
- Portsmouth, NH
- NPI 1528687829
-
- Diagnostic Radiology Physician
- Somersworth, NH
- NPI 1295326494
-
- Addiction (Substance Use Disorder) Counselor
- Dover, NH
- NPI 1710504683
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dover, NH
- NPI 1033118104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1043984586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "789 CENTRAL AVE",
"city": "DOVER",
"state": "NH",
"postal_code": "038202526",
"telephone_number": "603-609-6925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-724-4500"
}
],
"practiceLocations": [
{
"address_1": "789 Central Ave",
"address_purpose": "LOCATION",
"city": "Dover",
"state": "NH",
"postal_code": "038202526",
"country_code": "US",
"telephone_number": "603-609-6925",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "ROBERT",
"middle_name": "JAMES",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-08",
"last_updated": "2024-04-29",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN210429",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NH",
"license": "088716-23",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3138060",
"state": "NH"
}
],
"endpoints": [],
"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 Apr 29, 2024; 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.