Sonnly Ribourg, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5114 Issued in MA

Practice address

195 Canal St
Malden, MA 02148-6701

Phone

(781) 338-0500

NPI assigned

Aug 1, 2014

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sribourg61952@direct.challiance.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.

• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1932313228
  Medicare reassignment Care Compare group NPD
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  NPD

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

• Cambridge Public Health Commission

  • Clinic/Center
  • Cambridge, MA
  • NPI 1306908405

  Hospital

  Care Compare affiliation
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  Care Compare affiliation

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1154739241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 HANCOCK ST",
            "address_2": "APT 1",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021491333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 CANAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486701",
            "telephone_number": "781-338-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBOURG",
        "first_name": "SONNLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-01",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "5114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalia Restrepo
• Revive Counseling and Wellness Center
• Prona Nakubulwa Rex, BSN
• Cari Reynolds
• Paola M Rhodes, BA
• Brianna Kymarie Riccio
• Patrick Joseph Richard, DMD
• Mackenzie Richards
• David H Richman, MD
• Rita Rieves

• Physician Assistant in Malden, MA
• Providers in Malden, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.