Individual provider Active NPI

Ryan Garrity

  • Clinical Neuropsychologist
  • Arlington, MA
National Provider Identifier
1306864319
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7977 Issued in MA
Practice address
180 Massachusetts Ave
Suite 302
Arlington, MA 02474-8448
Phone
(339) 707-6041
Fax
(339) 707-6726
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 7977 MA Primary
Clinical Neuropsychologist 103G00000X PS00771 RI

Addresses

Primary practice location

180 Massachusetts Ave
Suite 302
Arlington, MA 02474-8448

Mailing address

28 Pontiac Rd
Walpole, MA 02081-4255

Other identifiers 1

IdentifierTypeStateIssuer
W06150OtherMABLUE CROSS/BS OF MA

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
I20040726000313 MA Practitioner - Clinical Psychologist 1052391455 Reassigns benefits to 2 organizations
Practice locations: Salem, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
North Shore Medical Center, Inc.Group PAC ID 3274427570, 44 clinicians

Practice addresses (Care Compare)

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 825-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS00771RIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Pathology Partners, P.C. Current Accepting new patients
North Shore Medical Center, Inc. CurrentSince Sep 13, 2002 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Nov 27, 2018 Accepting new patients
North Shore Medical Center, Inc. CurrentSince Sep 13, 2002 Accepting new patients
NSPG Billing LLC Past Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

57 Highland Ave
Fl 2
Salem, MA 01970
Phone (617) 922-4585

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306864319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 PONTIAC RD",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020814255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MASSACHUSETTS AVE",
            "address_2": "SUITE 302",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024748448",
            "telephone_number": "339-707-6041",
            "fax_number": "339-707-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRITY",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "7977",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "PS00771",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BS OF MA",
            "identifier": "W06150",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

Verify at the official NPI Registry.