Individual provider Active NPI

Casey L Evans, PHD

  • Psychologist
  • Boston, MA
National Provider Identifier
1912420423
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
11926 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-2000
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 11926 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

55 Fruit St
Boston, MA 02114-2696

Other practice location 1

151 Everett Ave
MGH Chelsea HealthCare Ctr.
Chelsea, MA 02150-1812
Phone (617) 884-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221214000852 MA Practitioner - Clinical Psychologist 8426427402 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11926MAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Nov 10, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Nov 10, 2022 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

151 Everett Ave
Chelsea, MA 02150
Phone (617) 884-8300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1912420423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Everett Ave",
            "address_2": "MGH Chelsea HealthCare Ctr.",
            "address_purpose": "LOCATION",
            "city": "Chelsea",
            "state": "MA",
            "postal_code": "021501812",
            "country_code": "US",
            "telephone_number": "617-884-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "CASEY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.