Individual provider Active NPI

Rob Ridlon

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1184054702
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MC 13675 Issued in ME
Practice address
221 Longwood Ave
Boston, MA 02115
Phone
(617) 732-6766
NPI assigned
Nov 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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 MC 13675 ME Primary

Addresses

Primary practice location

221 Longwood Ave
Boston, MA 02115

Mailing address

221 Longwood
Psych Department
Boston, MA 02115
Phone (617) 732-6766

Other practice location 1

66 State St
Portland, ME 04101-3751
Phone (207) 272-2120

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
I20150812007436 MA Practitioner - Clinical Social Worker 7113232786 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC 13675MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Oct 25, 2023 Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince May 1, 2015 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

Interoperability endpoints

  • Direct secure messaging: ridlon.robert.bwh@direct.partners.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1184054702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD",
            "address_2": "PSYCH DEPARTMENT",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-6766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 State St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041013751",
            "country_code": "US",
            "telephone_number": "207-272-2120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDLON",
        "first_name": "ROB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-18",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC 13675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.