Active NPI
Mary Katherine Evans, PTMS
- Pediatric Physical Therapist
- Concord, MA
National Provider Identifier
1619158458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 4532
- Practice address
- 1269 Main St
Concord, MA 01742-3099 - Phone
- (978) 287-7800
- NPI assigned
- Nov 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 4532 | MA | Primary |
Addresses
Primary practice location
1269 Main St
Concord, MA 01742-3099
Mailing address
1269 Main St
Concord, MA 01742-3099
Phone (978) 287-7800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
289 Great Rd
Suite 306
Acton, MA 01720-4766
Phone (508) 667-0114
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Health 360 LLC | Pediatrics | Current | Accepting new patients |
Locations
289 Great Rd
Ste 306
Acton, MA 01720
Phone (508) 667-0114
Organizations & group practices 1
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": "1195516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1619158458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1269 MAIN ST",
"city": "CONCORD",
"state": "MA",
"postal_code": "017423099",
"telephone_number": "978-287-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1269 MAIN ST",
"city": "CONCORD",
"state": "MA",
"postal_code": "017423099",
"telephone_number": "978-287-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "MARY",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "PTMS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-20",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "MA",
"license": "4532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.