Individual provider Active NPI

Evan Fox, MD

  • Psychiatry Physician
  • Glastonbury, CT
National Provider Identifier
1598837429
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
031192 Issued in CT
Practice address
300 Hebron Ave
Suite 107
Glastonbury, CT 06033
Phone
(860) 430-1150
Fax
(860) 430-1093
NPI assigned
Nov 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 031192 CT Primary

Addresses

Primary practice location

300 Hebron Ave
Suite 107
Glastonbury, CT 06033

Mailing address

300 Hebron Ave
Suite 107
Glastonbury, CT 06033
Phone (860) 430-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20051219000561 CT Practitioner - Psychiatry 7911929906 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

300 Hebron Ave
Suite 107
Glastonbury, CT 06033-2176
Phone (860) 430-1150

80 Seymour St
Hartford, CT 06102-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
031192CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital Psychiatry CurrentSince Jan 31, 1994 Accepting new patients
Evan Fox MD, LLC CurrentSince Dec 29, 2012 Accepting new patients
Hartford Hospital CurrentSince Sep 22, 1993 Accepting new patients

Locations

300 Hebron Ave
Ste 107
Glastonbury, CT 06033
Phone (860) 430-1150

400 Washington St
Hartford, CT 06106
Phone (860) 545-7229

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598837429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HEBRON AVE",
            "address_2": "SUITE 107",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "06033",
            "telephone_number": "860-430-1150",
            "fax_number": "860-430-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEBRON AVE",
            "address_2": "SUITE 107",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "06033",
            "telephone_number": "860-430-1150",
            "fax_number": "860-430-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "031192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.