Individual provider Active NPI

Evangelos Nomikos, M.ED

  • Addiction (Substance Use Disorder) Counselor
  • South Boston, MA
National Provider Identifier
1932642147
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
210 Old Colony Ave
South Boston, MA 02127-2413
Phone
(617) 268-5000
Fax
(617) 268-5008
NPI assigned
Nov 21, 2016
Last updated
Nov 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

210 Old Colony Ave
South Boston, MA 02127-2413

Mailing address

210 Old Colony Ave
South Boston, MA 02127-2413
Phone (617) 268-5000

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
I20240520001985 MA Practitioner - Mental Health Counselor 9133561335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

529 R High St
Dedham, MA 02026-1858
Phone (617) 383-1033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Lucky Day Counseling, LLC Addiction (Substance Use Disorder) CurrentSince May 7, 2024 Accepting new patients

Locations

529 High St
#R
Dedham, MA 02026
Phone (617) 383-1033

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1932642147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272413",
            "telephone_number": "617-268-5000",
            "fax_number": "617-268-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272413",
            "telephone_number": "617-268-5000",
            "fax_number": "617-268-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOMIKOS",
        "first_name": "EVANGELOS",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

Verify at the official NPI Registry.