Individual provider Active NPI

Ryan Francis Horn, LICSW

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1114405172
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121674 Issued in MA
Practice address
165 Quincy St
Brockton, MA 02302-2988
Phone
(508) 897-2082
Fax
(508) 897-2044
NPI assigned
Aug 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 121674 MA Primary

Addresses

Primary practice location

165 Quincy St
Brockton, MA 02302-2988

Mailing address

165 Quincy St
Brockton, MA 02302-2988
Phone (508) 897-2082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190411001973 MA Practitioner - Clinical Social Worker 5799026159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of Massachusetts 141 clinicians

Practice addresses (Care Compare)

165 Quincy St
Brockton, MA 02302-2988
Phone (508) 897-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121674MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Aug 3, 2022 Accepting new patients

Locations

165 Quincy St
Brockton, MA 02302
Phone (508) 897-2000

40 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 732-3000

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1114405172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022988",
            "telephone_number": "508-897-2082",
            "fax_number": "508-897-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022988",
            "telephone_number": "508-897-2082",
            "fax_number": "508-897-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "RYAN",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.