Evelyn Eccles, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301043902 Issued in MI

Practice address

122 W Main St
Box 570
Manchester, MI 48158-1002

Phone

(734) 428-8381

Fax

(734) 428-9066

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Family Practice

Education

University of Michigan Medical School, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274
• Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092
• Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: eeccles495166@direct.hfhs.org

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.

• Evelyn Eccles, MD

  • Family Medicine Physician
  • Manchester, MI
  • NPI 1679776264
  NPD (past) Authorized official

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

• Emma L. Bixby Medical Center

  • General Acute Care Hospital
  • Adrian, MI
  • NPI 1972564730
  Care Compare affiliation
• Great Lakes Home Health Services, Inc.

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation
• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation
• St Joseph Mercy Chelsea Inc

  • General Acute Care Hospital
  • Chelsea, MI
  • NPI 1992761985
  Care Compare affiliation
• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation
• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1366533689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W MAIN ST",
            "address_2": "BOX 570",
            "city": "MANCHESTER",
            "state": "MI",
            "postal_code": "481581002",
            "telephone_number": "734-428-8381",
            "fax_number": "734-428-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W MAIN ST",
            "address_2": "BOX 570",
            "city": "MANCHESTER",
            "state": "MI",
            "postal_code": "481581002",
            "telephone_number": "734-428-8381",
            "fax_number": "734-428-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECCLES",
        "first_name": "EVELYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301043902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0811119",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802237",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridgewater Support Services, LLC
• Amber Dawn Burkhardt-Sidebottom, LMSW
• Allan R Currey, D.D.S.
• Jay Michael Demski, PHARM.D.
• Miranda Eberle, DDS
• Evelyn Eccles, MD
• Claudia J Fall, PMHNP-BC
• Brooke Fuller, AT, ATC
• Great Lakes Bay Health Centers
• Debra Hauser, PT

• Family Medicine Physician in Manchester, MI
• Providers in Manchester, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.