Individual provider Active NPI

Samatha Evans, FNP-C

  • Family Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1528643624
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2295578 Issued in MA
Practice address
479 Torrey St
Brockton, MA 02301-4617
Phone
(774) 470-6700
Fax
(774) 470-6716
NPI assigned
Mar 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2295578 MA
Family Nurse Practitioner 363LF0000X RN2295578 MA Primary

Addresses

Primary practice location

479 Torrey St
Brockton, MA 02301-4617

Mailing address

479 Torrey St
Brockton, MA 02301-4617
Phone (774) 470-6700

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713003410 MA Practitioner - Nurse Practitioner 0941602924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2295578MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Harbor Health Services, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Harbor Health Services Inc PastSince Dec 15, 2024 Accepting new patients

Locations

250 Mount Vernon St
Dorchester, MA 02125
Phone (617) 288-1140

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

Interoperability endpoints

  • Direct secure messaging: samatha.evans.p1@direct.hhsi.nextgenshare.com
  • Direct secure messaging: sevans811903@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1528643624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014617",
            "telephone_number": "774-470-6700",
            "fax_number": "772-470-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014617",
            "telephone_number": "774-470-6700",
            "fax_number": "774-470-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SAMATHA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2295578",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2295578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.