Theresa Evans – Adult Health Nurse Practitioner

Key facts

NPI: 1134524697
Entity type: Individual (NPI type 1)
Primary specialty: Adult Health Nurse Practitioner 363LA2200X
License: 217792 (MA)
Practice address: 79 Mace Rd
Hampton, NH 03842-2052
Phone: (857) 498-1023
NPI assigned: Oct 27, 2014
Sex: Female
Sole proprietor: No

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.

The General Hospital Corporation General Acute Care Hospital · Boston, MA · NPI 1023049236

Medicare reassignment Care Compare group NPD MA
Massachusetts General Physicians Organization Inc Dermatology Physician · Boston, MA · NPI 1801874573

Medicare reassignment NPD MA
General Hospital Corp General Acute Care Hospital · Boston, MA · NPI 1508390014

NPD

Hospital & facility affiliations 1

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

The General Hospital Corporation General Acute Care Hospital · Boston, MA · NPI 1023049236

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2003
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: The General Hospital Corporation (1,275 clinicians)

Practice addresses (Care Compare)

102 Endicott St
Danvers, MA 01923-3623
Phone (978) 882-6100

104 Endicott St
Danvers, MA 01923-3623
Phone (978) 882-6100

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Hospital & facility affiliations

Massachusetts General Hospital Hospital · Boston, MA · CCN 220071

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20170809002607	MA	Practitioner - Nurse Practitioner	6002187077	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Certified Nurse Practitioner, Master of Science

State licenses

License	State	Type	Specialty
217792	MA	MD	Social Worker

Practice roles

Organization	Status	New patients
General Hospital Corp	Current	Accepting new patients
The General Hospital Corporation	Current since May 31, 2017	Accepting new patients
Massachusetts General Physicians Organization Inc	Current since May 31, 2017	Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

Direct secure messaging: evans.theresa.mgh@direct.partners.masshiway.net

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Health Nurse Practitioner	363LA2200X	217792	MA	Yes

Addresses

Primary practice location

79 Mace Rd
Hampton, NH 03842-2052

Mailing address

79 Mace Rd
Hampton, NH 03842-2052

Other providers in Hampton, NH

All providers in Hampton, NH · Adult Health Nurse Practitioner in New Hampshire

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.