Individual provider Active NPI

Ryan Beveridge, PH.D.

  • Clinical Psychologist
  • Newark, DE
National Provider Identifier
1336031269
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
B1-0000862 Issued in DE
Practice address
100 Discovery Blvd.
Icmh, Star Tower, 6TH Floor
Newark, DE 19713
Phone
(302) 831-2717
NPI assigned
Jul 16, 2025
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X B1-0000862 DE Primary

Addresses

Primary practice location

100 Discovery Blvd.
Icmh, Star Tower, 6TH Floor
Newark, DE 19713

Mailing address

1034 Saint Georges LN
Landenberg, PA 19350-1320
Phone (801) 502-6673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20251023000762 DE Practitioner - Clinical Psychologist 2163910928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Discovery Blvd
Newark, DE 19713-1313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
B1-0000862DEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ud Health LLC CurrentSince Jul 22, 2025 Accepting new patients
Ud Health LLC Clinical CurrentSince Aug 10, 2025 Accepting new patients

Locations

100 Discovery Blvd
Fl 6
Newark, DE 19713
Phone (302) 831-2717

540 S College Ave
Ste 160
Newark, DE 19713
Phone (302) 831-3000

Organizations & group practices 2

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": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1336031269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 SAINT GEORGES LN",
            "city": "LANDENBERG",
            "state": "PA",
            "postal_code": "193501320",
            "telephone_number": "801-502-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DISCOVERY BLVD.",
            "address_2": "ICMH, STAR TOWER, 6TH FLOOR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-831-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERIDGE",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0000862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.