NPIMap

Individual provider Active NPI

Evan B Weisman, MD

  • Family Medicine Physician
  • Braintree, MA
National Provider Identifier
1659304319
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
156689 Issued in MA
Practice address
340 Wood Rd Ste 101
Braintree, MA 02184-2404
Phone
(781) 843-0705
Fax
(781) 843-3809
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 156689 MA Primary

Addresses

Primary practice location

340 Wood Rd Ste 101
Braintree, MA 02184-2404

Mailing address

PO Box 68
S Weymouth, MA 02190-0001
Phone (781) 843-0705

Other identifiers 3

IdentifierTypeStateIssuer
BX8381OtherMAMEDICARE PTAN
31910021MedicaidMA
A2904601OtherMAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040527000682 MA Practitioner - Family Practice 4587645312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthcare South PCGroup PAC ID 0941273262, 24 clinicians

Practice addresses (Care Compare)

340 Wood Rd
Suite 101
Braintree, MA 02184-2404
Phone (781) 803-2786

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.78 of 100Reported as individual
Quality
84.32
Promoting interoperability
0
Improvement activities
40
Cost
68.29

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare South PC Family Medicine CurrentSince Jul 24, 2017 Accepting new patients

Locations

340 Wood Rd
Ste 101
Braintree, MA 02184
Phone (781) 803-2786

56 New Driftway
Ste 301
Scituate, MA 02066
Phone (781) 383-6261

Interoperability endpoints

  • Direct secure messaging: evanweisman@hcs.allscriptsdirect.net

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.

Hospital & facility affiliations 8

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659304319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "S WEYMOUTH",
            "state": "MA",
            "postal_code": "021900001",
            "telephone_number": "781-843-0705",
            "fax_number": "781-843-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 WOOD RD STE 101",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842404",
            "telephone_number": "781-843-0705",
            "fax_number": "781-843-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISMAN",
        "first_name": "EVAN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "156689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BX8381",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31910021",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A2904601",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.