Evan Provisor, MD
NPI 1366427429 · Surgery Physician · Southbridge, MA
Enrolled with Medicare as Practitioner - General Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Evan Provisor, MD is a Surgery Physician provider in Southbridge, MA (NPI 1366427429).
Provider details
- NPI number
- 1366427429
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 237945 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2005-12-13
- Last updated
- 2011-12-21
Frequently asked questions
- What is Evan Provisor's NPI number?
- Evan Provisor's National Provider Identifier (NPI) is 1366427429, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Evan Provisor's specialty?
- Evan Provisor is listed in the NPPES registry with a primary specialty of Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Evan Provisor located?
- Evan Provisor's practice location on file with NPPES is 94 South St, Southbridge, MA 01550-4000.
- What is Evan Provisor's phone number?
- The practice phone number listed in the NPPES registry for Evan Provisor is (508) 764-6966.
- Does Evan Provisor accept Medicare?
- Evan Provisor is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Evan Provisor's NPI active?
- Yes — Evan Provisor's NPI (1366427429) is active in the NPPES registry as of the last update on 2011-12-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.