Jenny A Evans, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1857 Issued in MA

Practice address

360 Merrimack St
Lawrence, MA 01843-1740

Phone

(978) 557-8800

Fax

(978) 557-8633

NPI assigned

Oct 4, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jenny A Moulton Other name

Medicare fee-for-service enrollment

Enrolled in MA, NH2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mass General Brigham Medical Group Northern Massachusetts IncGroup PAC ID 3577467224, 817 clinicians

Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evans.jenny.pma@direct.partners.masshiway.net

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.

• Mass General Brigham Community Physicians Inc.

  • Internal Medicine Physician
  • Haverhill, MA
  • NPI 1891112637
  Medicare reassignment Care Compare group NPD
• Mass General Brigham Medical Group Northern Massachusetts Inc

  • Emergency Medicine Physician
  • Salem, MA
  • NPI 1588606123
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Physicians of Rockingham County, LLC

  • Emergency Medicine Physician
  • Exeter, NH
  • NPI 1174956668
  Medicare reassignment
• Mass General Brigham Community Physicians Inc

  • Cardiovascular Disease Physician
  • Medford, MA
  • NPI 1548638265
  NPD
• Exeter Emergency Physicians PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Exeter, NH
  • NPI 1497845101
  NPD (past)

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

• North Shore Medical Center, Inc.

  dba Salem Hospital

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649365610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431756",
            "telephone_number": "978-557-8900",
            "fax_number": "978-557-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431740",
            "telephone_number": "978-557-8800",
            "fax_number": "978-557-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JENNY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00791691",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30334648",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432389499",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "MOULTON",
            "middle_name": "A",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Grismar Estevez
• Kenia Estevez, M.A.
• Nakita Maria Estevez, LPN
• Brenna Marie Evans
• Jeanne Marilyn Evans, MSW
• Eye Institute of the Merrimack Valley Inc
• Gerard Philip Eyssallenne
• Ez Med Services
• Lisa Fabbri Lopez, M.A.
• Jessie Fabian

• Physician Assistant in Lawrence, MA
• Providers in Lawrence, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.