EVAN ROBERT KETCHAM
NPI 1407559909
Student in an Organized Health Care Education/Training Program in Lebanon, NH
About Evan Robert Ketcham NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVAN ROBERT KETCHAM (NPI 1407559909) is an individual student in an organized health care education/training program in Lebanon, New Hampshire and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Evan Robert Ketcham is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Evan Ketcham reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Concord, NH 03301
- Reassigned Medicare billing, New Hampshire enrollment
- 120 clinicians in this Medicare group
Keene, NH 03431
- Reassigned Medicare billing, New Hampshire enrollment
- 23 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Evan Ketcham's NPI number?
The NPI number for Evan Ketcham is 1407559909. It was assigned to this individual provider in the NPPES registry on March 23, 2023.
Where is Evan Ketcham located?
Evan Ketcham practices at 1 Medical Center Dr, Lebanon, NH 03756. The listed phone number is (603) 650-5000.
What is Evan Ketcham's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Evan Ketcham enrolled in Medicare?
Yes. Evan Ketcham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Evan Ketcham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Evan Ketcham reassigns Medicare benefits to 2 organizations: State Of New Hampshire (Concord, NH) and Monadnock Family Services (Keene, NH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Evan Ketcham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Evan Ketcham was last updated on March 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Evan Robert Ketcham · NPI 1407559909
Student in an Organized Health Care Education/Training Program provider in Lebanon, New Hampshire. Individual provider, active in the CMS NPPES registry since March 23, 2023.
## Identity
- **NPI:** 1407559909 (Entity type: Individual)
- **Enumerated:** March 23, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1 MEDICAL CENTER DR, Lebanon, NH 03756-0001
- **Phone:** (603) 650-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): State Of New Hampshire (NPI 1861491334, Concord, NH); Monadnock Family Services (NPI 1649331224, Keene, NH) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** March 23, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1407559909) · Data from the CMS NPPES public registry.