Evans M Mutua, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209-017928 Issued in IL

Practice address

720 N Bond St
Springfield, IL 62702-4952

Phone

(217) 545-8000

Fax

(217) 545-6544

NPI assigned

Sep 25, 2018

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evansmutua@siusm.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment Care Compare group NPD
• Board of Trustees of Southern Illinois University

  dba Carbondale Care A Van

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD

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

• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1265917371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19662",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949662",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N BOND ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024952",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTUA",
        "first_name": "EVANS",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-017928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evansmutua@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "720 N Bond St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627024952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chinmayee Murthy, MD
• Marcus Allen Mussatto
• Amanda Musselman, RBT
• Courtney Musselman, APRN
• Whitney Laine Musselman, OTR
• Ife Muyiwa-Ojo, NP
• Tinashe Florence Muzorewa, MD
• Thandeka Myeni, M.D.
• James Edward Myers, PSY.D.
• Phillip W Myers, M.D.

• Family Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.

Verify at the official NPI Registry.