Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Evan Nathan Dickstein, NP-PMH

Individual provider Registered Nurse · NPI 1942688379

Mr. Evan Nathan Dickstein, NP-PMH is a Nurse Practitioner in Frederick, Maryland. Qualified in 2015, 11 years ago. Practices with Privia Medical Group, LLC, a 1,518-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
11
Licensed in
MD
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

5301 Buckeystown Pike
Frederick, MD 21704-8370
Phone: (301) 733-0330
Fax: (301) 733-4038
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence R200789 (MD)
Registered Nurse Taxonomy 163W00000X · Licence R200789 (MD)

Record details

NPI number1942688379
Entity typeIndividual (Type 1)
GenderMale
Credentials NP-PMH
Sole proprietorNo
NPI enumeratedMay 18, 2015
Last updated in NPPESFebruary 15, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Privia Medical Group, Llc — 1518 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Frederick