Evan Paul Provisor, MD in Southbridge, MA

Evan Paul Provisor, MD is a medicare enrolled "Surgery" physician in Southbridge, Massachusetts. His current practice location is 94 South St, Southbridge, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (508) 764-6966.

Evan Paul Provisor is licensed to practice in Massachusetts (license number 237945) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1366427429.

Contact Information

	Evan Paul Provisor, MD
	94 South St, Southbridge, MA 01550-4000
	(508) 764-6966
	(508) 764-2457

Map and Direction

Physician's Profile

Full Name	Evan Paul Provisor
Gender	Male
Speciality	Surgery
Location	94 South St, Southbridge, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366427429
Provider Enumeration Date: 12/13/2005
Last Update Date: 12/21/2011

Medicare PECOS Information:

PECOS PAC ID: 8022045947
Enrollment ID: I20081017000114

Medical Identifiers

Medical identifiers for Evan Paul Provisor such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366427429	NPI	-	NPPES
2160307	Medicaid	MA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	237945 (Massachusetts)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Evan Paul Provisor allows following entities to bill medicare on his behalf.

Entity Name	Umass Memorial Health-harrington Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790780047 PECOS PAC ID: 8123087319 Enrollment ID: O20041004001081

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evan Paul Provisor is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Evan Paul Provisor, MD 94 South St, Southbridge, MA 01550-4000 Ph: (508) 764-6966	Evan Paul Provisor, MD 94 South St, Southbridge, MA 01550-4000 Ph: (508) 764-6966

Reviews and Comments

Surgery Doctors in Southbridge, MA

Stephen T Hilborn, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 94 South St, Harrington Physician Services, Southbridge, MA 01550 Phone: 508-764-2772 Fax: 508-764-2833
Konstantino A Avradopoulos, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 94 South St, Southbridge, MA 01550 Phone: 508-764-6966 Fax: 508-764-2457
Brian E Wolf, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 100 South St, Southbridge, MA 01550 Phone: 508-765-9771 Fax: 508-764-2448
Dr. Harry Watkey Easterly Iii, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 94 South St, Southbridge, MA 01550 Phone: 508-764-6966 Fax: 508-764-2457
Warren William Rose, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 100 South St Ste 108, Southbridge, MA 01550 Phone: 508-764-6966 Fax: 508-764-2457
Thomas W Johnson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 100 South St, Suite 108, Southbridge, MA 01550 Phone: 508-764-6966 Fax: 508-764-2457

Evan Paul Provisor, MD - Medicare Surgery in Southbridge, MA