Individual provider Active NPI

Ryan Andrew Mace, PHD

  • Psychologist
  • Boston, MA
National Provider Identifier
1285154401
Registry record updated Nov 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
11620 Issued in MA
Practice address
15 Webster Ave Unit 1
Boston, MA 02128-2821
Phone
(857) 244-0209
NPI assigned
Jun 20, 2017
Last updated
Nov 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 11620 MA Primary

Addresses

Primary practice location

15 Webster Ave Unit 1
Boston, MA 02128-2821

Mailing address

1 Bowdoin SQ FL 1
Boston, MA 02114-2927
Phone (617) 643-7841

Other practice location 1

1 Bowdoin Sq Fl 1
Boston, MA 02114-2927
Phone (617) 643-7641

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
I20220429000954 MA Practitioner - Clinical Psychologist 7517354111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Bowdoin SQ
Boston, MA 02114-2927
Phone (617) 726-1444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11620MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: mace.ryan.mgh@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699747200000",
    "number": "1285154401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOWDOIN SQ FL 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142927",
            "telephone_number": "617-643-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WEBSTER AVE UNIT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021282821",
            "telephone_number": "857-244-0209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bowdoin Sq Fl 1",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142927",
            "country_code": "US",
            "telephone_number": "617-643-7641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACE",
        "first_name": "RYAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2023-11-12",
        "certification_date": "2023-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.