Active NPI
Evan Shreck, M.D.
- Urology Physician
- Meriden, CT
National Provider Identifier
1912360231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 67053
- Practice address
- 455 Lewis Ave Ste 210
Meriden, CT 06451-2121 - Phone
- (203) 238-1241
- NPI assigned
- Apr 4, 2016
- Last updated
- Apr 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Urology Physician | 208800000X | 67053 | CT | Primary |
Addresses
Primary practice location
455 Lewis Ave Ste 210
Meriden, CT 06451-2121
Mailing address
455 Lewis Ave Ste 210
Meriden, CT 06451-2121
Other practice location 1
111 E 210th St
Bronx, NY 10467
Phone (718) 696-2583
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- State University of New York at Stony Brook, School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
455 Lewis Ave
Meriden, CT 06451-2121
Phone (203) 694-8808
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Urology | Current | Accepting new patients |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients |
Locations
280 S Main St
Cheshire, CT 06410
Phone (203) 250-0060
455 Lewis Ave
Ste 210
Meriden, CT 06451
Phone (203) 238-1241
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Interoperability endpoints
- eshreck@xdr.hhchealthdirect.org
Organizations & group practices 2
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.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
Urology
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Meriden, CT
- NPI 1427007848
-
- General Acute Care Hospital
- Meriden, CT
- NPI 1669524187
-
- General Acute Care Hospital
- New Britain, CT
- NPI 1548225360
-
dba The Hospital of Central Connecticut
- General Acute Care Hospital
- New Britain, CT
- NPI 1053477075
-
- General Acute Care Hospital
- New Haven, CT
- NPI 1336139500
-
- General Acute Care Hospital
- New Haven, CT
- NPI 1578778726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619136000000",
"number": "1912360231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 LEWIS AVE STE 210",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064512121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 LEWIS AVE STE 210",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064512121",
"telephone_number": "203-238-1241"
}
],
"practiceLocations": [
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "10467",
"country_code": "US",
"telephone_number": "718-696-2583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHRECK",
"first_name": "EVAN",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-04",
"last_updated": "2021-04-23",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CT",
"license": "67053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.