Ryan Keogh, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2331463 Issued in MA

Practice address

55 Fruit St
Boston, MA 02114-2696

Phone

(617) 724-9110

NPI assigned

Apr 3, 2013

Reactivated

Oct 20, 2021

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

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keogh.ryan.mgh@direct.partners.masshiway.net

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.

• Eliot Community Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Concord, MA
  • NPI 1679648182
  Medicare reassignment NPD
• Eliot Community Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, MA
  • NPI 1932271632
  NPD
• General Hospital Corp

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1508390014
  NPD

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1154664670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-724-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-724-9110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Hartwell Ave",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "MA",
            "postal_code": "024213100",
            "country_code": "US",
            "telephone_number": "781-861-0890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEOGH",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "deactivation_date": "2021-09-20",
        "reactivation_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2331463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine J Kentoffio, MD
• Alex Kentsis, MD, PHD
• Alicia Lynn Kenyon
• Deirdre Marie Keogh, NP
• John Taylor Keogh, PSY.D.
• Emily Keohane
• Anya Victoria Keomurjian
• William Lawrence Keough, MD
• Elliot Kephart
• Lucia Kepler, LMT

• Psychiatric/Mental Health Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.