Evan R Greenwald, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

477 Issued in NH

Practice address

1 Main St
Nashua, NH 03064-2716

Phone

(603) 883-0005

Fax

(603) 883-0007

NPI assigned

Jun 9, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 4, 2023 through Aug 4, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Interoperability endpoints

• Direct secure messaging: ccn.evangreenwald@140126.advancedmd-direct.com

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1477594596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030642716",
            "telephone_number": "603-883-0005",
            "fax_number": "603-883-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030642716",
            "telephone_number": "603-883-0005",
            "fax_number": "603-883-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWALD",
        "first_name": "EVAN",
        "middle_name": "R",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80001218",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greenbriar Operations LLC
• David Jonathan Greene, D.M.D.
• Emma Greene
• Nicole Greene, MS, OTR/L
• Karri-Ann Greenhalge
• Greenwood Dental Associates PLLC
• David Gregg
• Amber Rose Gregoire
• Wendylynne Weinbeck Grenier, D.C.
• Jennifer Griffin, NP-C

• Clinical Psychologist in Nashua, NH
• Providers in Nashua, NH by specialty
• Clinical Psychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.