Evan Andrew Malkiewich, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122244 Issued in MA

Practice address

1 Boston Medical Center
Boston, MA 02118

Phone

(617) 414-5245

Fax

(617) 414-5520

NPI assigned

Sep 10, 2014

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

Medicare fee-for-service enrollment

Enrolled in MA

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

The Bridge of Central Massachusetts IncGroup PAC ID 1658694393, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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 Bridge of Central Massachusetts, Inc.

  • Community/Behavioral Health Agency
  • Worcester, MA
  • NPI 1740657527
  Medicare reassignment Care Compare group NPD
• The Bridge of Central Massachusetts, Inc

  • Foster Care Agency
  • Worcester, MA
  • NPI 1053746255
  NPD

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1487055372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 MORELAND ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-5245",
            "fax_number": "617-414-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALKIEWICH",
        "first_name": "EVAN",
        "middle_name": "ANDREW",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-10",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Richard Malinn, FNP-BC
• Matthew Malinn, DPT
• Paige K Malinowski, MSW, LCSW
• Lauren Elizabeth Malishchak, MD
• Julia Rachel Malits, MD
• Alexis G. Malkin, O.D.
• Victoria Mallada
• Christopher Adam Mallard, MD
• Shreya Mallena
• Robert M Mallery, MD

• Clinical Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.