Individual provider Active NPI

Ryan Sutherland, MD

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1114380433
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1020017 Issued in MA
Practice address
55 Lake Ave North
Worcester, MA 01655-0002
Phone
(508) 334-3850
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1020017 MA Primary
Diagnostic Radiology Physician 2085R0202X D85885 MD

Addresses

Primary practice location

55 Lake Ave North
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

22 S Greene St
Dept of Radiology
Baltimore, MD 21201-1544
Phone (410) 328-3477

Other identifiers 2

IdentifierTypeStateIssuer
008656800MedicaidMD
039918288MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, MA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210510000434 MD Practitioner - Diagnostic Radiology 7618261678 Reassigns benefits to 5 organizations
I20210510001480 DC Practitioner - Diagnostic Radiology 7618261678 Reassigns benefits to 1 organization
I20240603004019 MA Practitioner - Diagnostic Radiology 7618261678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Florida State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians
University of Maryland Diagnostic Imaging Specialists P aGroup PAC ID 7719873298, 81 clinicians

Practice addresses (Care Compare)

West Friendship, MD 21794
Phone (508) 334-3850

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5700

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019
  • Marlborough Hospital Hospital, Marlborough, MA, CCN 220049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jun 1, 2024 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients

Locations

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

10 Little Brook Rd
West Wareham, MA 02576

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

5 N La Plata Ct
Ste 104
La Plata, MD 20646
Phone (301) 539-0345

Organizations & group practices 9

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1114380433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE NORTH",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_2": "DEPT OF RADIOLOGY",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-3477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1020017",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D85885",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008656800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039918288",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.