Active NPI
Patrick Ryan Realuyo Relator
- General Practice Dentistry
- Hyde Park, MA
National Provider Identifier
1386406791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN10001020
- Practice address
- 912 River St
Hyde Park, MA 02136-3715 - Phone
- (617) 910-4028
- NPI assigned
- Jan 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN10001020 | MA | Primary |
Addresses
Primary practice location
912 River St
Hyde Park, MA 02136-3715
Mailing address
645 Albany St
Boston, MA 02118
Phone (617) 358-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN10001020 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758067200000",
"number": "1386406791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 ALBANY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118",
"telephone_number": "617-358-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 RIVER ST",
"city": "HYDE PARK",
"state": "MA",
"postal_code": "021363715",
"telephone_number": "617-910-4028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RELATOR",
"first_name": "PATRICK RYAN",
"middle_name": "REALUYO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-30",
"last_updated": "2025-09-17",
"certification_date": "2025-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN10001020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyde Park, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.