Cleveland Samuel Ricketts, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

330 Brookline Avenue
Boston, MA 02215

Phone

(617) 667-7000

NPI assigned

Apr 4, 2023

Reactivated

Aug 11, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: cricketts253308@direct.bilh.masshiway.net

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1043915424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LAUGHLIN",
            "city": "EAST STRATFORD",
            "state": "CT",
            "postal_code": "06614",
            "telephone_number": "203-684-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVENUE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "CLEVELAND",
        "middle_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-04",
        "last_updated": "2025-08-11",
        "certification_date": "2023-04-04",
        "deactivation_date": "2023-11-09",
        "reactivation_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Micheal Richter, MD
• Alyne Theresa Ricker, MD
• Elizabeth McCann Rickerson, M.D.
• Shuryl Angel Stephanie Rickerson
• Alyson Lin Rickert, MSW
• Lisa M Rickey, MD
• Sophie Ricks
• Janet S Rico, NP
• Daniel Nicholas Ricotta, MD
• Michelle Ann Ricupero, NP

• Student in an Organized Health Care Education/Training Program in Boston, MA
• Providers in Boston, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.