Individual provider Active NPI

Evelise Alicea, CNM

  • Advanced Practice Midwife
  • Boston, MA
National Provider Identifier
1528761228
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN2272646 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5500
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN2272646 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

5 Lakeshore Ctr Unit 1217
Bridgewater, MA 02324-1082
Phone (781) 975-2512

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927001303 MA Practitioner - Certified Nurse Midwife (CNM) 6608220447 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN2272646MAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Hospital, Inc. CurrentSince Aug 14, 2023 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Mattapan Community Health Center Inc Past Accepting new patients
Brigham & Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

Interoperability endpoints

  • Direct secure messaging: alicea.evelise.bwh@direct.partners.masshiway.net
  • Direct secure messaging: ealicea663844@direct.ochin.org

Organizations & group practices 4

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": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1528761228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAKESHORE CTR UNIT 1217",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023241082",
            "telephone_number": "781-975-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA",
        "first_name": "EVELISE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN2272646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.