Individual provider Active NPI

Ry K Billadeau, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Manchester, NH
National Provider Identifier
1073145199
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
070626-23 Issued in NH
Practice address
835 Hanover St Ste 305
Manchester, NH 03104-5401
Phone
(603) 784-9012
Fax
(603) 784-9012
NPI assigned
Feb 6, 2020
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 070626-23 NH Primary

Addresses

Primary practice location

835 Hanover St Ste 305
Manchester, NH 03104-5401

Mailing address

835 Hanover St Ste 305
Manchester, NH 03104-5401
Phone (603) 784-9012

Other practice location 1

35 Godfrey Ln
Fremont, NH 03044-3055
Phone (978) 419-1403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210210001706 NH Practitioner - Nurse Practitioner 6406261114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optimal Behavioral Health Services LLCGroup PAC ID 8729528468, 8 clinicians

Practice addresses (Care Compare)

35 Godfrey LN
Fremont, NH 03044-3055
Phone (603) 784-9012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Behavioral Health Services LLC CurrentSince Jul 27, 2024 Accepting new patients
Warren Street Family Counseling Assoc Inc CurrentSince Dec 5, 2020 Accepting new patients

Locations

835 Hanover St
Ste 305
Manchester, NH 03104
Phone (603) 770-6783

170 Commerce Way
Ste 200
Portsmouth, NH 03801
Phone (201) 293-7689

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1073145199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 HANOVER ST STE 305",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031045401",
            "telephone_number": "603-784-9012",
            "fax_number": "603-784-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 HANOVER ST STE 305",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031045401",
            "telephone_number": "603-784-9012",
            "fax_number": "603-784-9012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Godfrey Ln",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "NH",
            "postal_code": "030443055",
            "country_code": "US",
            "telephone_number": "978-419-1403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILLADEAU",
        "first_name": "RY",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-06",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "070626-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.