Individual provider Active NPI

Evan William Gwyn, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1154558500
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
240175 Issued in MA
Practice address
55 Fruit Street
Hospital Medicine Unit, Blake 1500
Boston, MA 02114
Phone
(617) 724-3874
Fax
(617) 724-9428
NPI assigned
Jun 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 240175 MA Primary

Addresses

Primary practice location

55 Fruit Street
Hospital Medicine Unit, Blake 1500
Boston, MA 02114

Mailing address

330 Brookline Ave
Span 2
Boston, MA 02215
Phone (617) 794-1338

Other practice location 1

1153 Centre St
Jamaica Plain, MA 02130-3446
Phone (617) 983-7000

Other practice location 2

330 Brookline Ave
Deaconess 311
Boston, MA 02215-5400
Phone (504) 669-3411

Other practice location 3

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120921000692 MA Practitioner - Internal Medicine 8527216217 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240175MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients
The General Hospital Corporation CurrentSince Jan 1, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Mar 1, 2026 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jan 1, 2015 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2012 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

55 Fruit St
#1500
Boston, MA 02114
Phone (617) 724-3842

330 Brookline Ave
#311
Boston, MA 02215
Phone (617) 754-0100

55 Fruit St
Boston, MA 02114

330 Brookline Ave
#2
Boston, MA 02215
Phone (617) 632-8383

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

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Interoperability endpoints

  • Direct secure messaging: gwyn.evan.mgh@direct.partners.masshiway.net

Organizations & group practices 11

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 1

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": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1154558500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "SPAN 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-794-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "HOSPITAL MEDICINE UNIT, BLAKE 1500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-724-3874",
            "fax_number": "617-724-9428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1153 Centre St",
            "address_purpose": "LOCATION",
            "city": "Jamaica Plain",
            "state": "MA",
            "postal_code": "021303446",
            "country_code": "US",
            "telephone_number": "617-983-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Brookline Ave",
            "address_2": "Deaconess 311",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "504-669-3411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWYN",
        "first_name": "EVAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-12",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "240175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.