Individual provider Active NPI

Evan Frank Marino, D.O.

  • Interventional Cardiology Physician
  • Methuen, MA
National Provider Identifier
1093000390
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
274837 Issued in MA
Practice address
99 Jackson St
Methuen, MA 01844
Phone
(978) 689-2540
Fax
(978) 689-2540
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 274837 MA Primary

Addresses

Primary practice location

99 Jackson St
Methuen, MA 01844

Mailing address

99 Jackson St
Methuen, MA 01844-5044
Phone (603) 548-5969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181002000703 MA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0840541819 Reassigns benefits to 3 organizations
I20230823001649 NH Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0840541819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

99 Jackson St
Methuen, MA 01844-5044
Phone (978) 689-2540

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting14
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Aug 1, 2023 Accepting new patients
Evan F Marino LLC Interventional Cardiology CurrentSince Dec 31, 2018 Accepting new patients

Locations

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

99 Jackson St
Methuen, MA 01844
Phone (978) 689-2540

1 Elliot Way
Ste 100
Manchester, NH 03103
Phone (603) 627-1669

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

4 Elliot Way
Manchester, NH 03103
Phone (603) 627-1669

Interoperability endpoints

  • Direct secure messaging: emarino155562@direct.solutionhealth.org
  • Direct secure messaging: evan.marino.1@5988.direct.athenahealth.com
  • Direct secure messaging: evan.marino.3@5988.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1093000390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 JACKSON ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445044",
            "telephone_number": "603-548-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 JACKSON ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "01844",
            "telephone_number": "978-689-2540",
            "fax_number": "978-689-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "EVAN",
        "middle_name": "FRANK",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MA",
            "license": "274837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

Verify at the official NPI Registry.