Individual provider Active NPI

Ryan Andrew Gise, M.D.

  • Ophthalmology Physician
  • Boston, MA
National Provider Identifier
1417214107
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
265093 Issued in MA
Practice address
243 Charles St
Boston, MA 02114
Phone
(617) 573-3412
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 265093 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114

Mailing address

243 Charles St
Boston, MA 02114-3002
Phone (617) 573-3412

Other practice location 1

55 Lake Ave North
Worcester, MA 01655
Phone (508) 334-1000

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180717003044 MA Practitioner - Ophthalmology 7214284678 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Boston University School of Medicine, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Childrens Hospital Ophthalmology Foundation IncGroup PAC ID 8729049150, 26 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265093MAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Ophthalmology Foundation Inc Ophthalmology CurrentSince Jul 5, 2019 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jan 21, 2025 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jul 1, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jan 21, 2025 Accepting new patients
Childrens Hospital Boston Past Accepting new patients
Children'S Hospital Pediatric Associates, Inc Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

75 Francis St
Boston, MA 02115

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: rgise27306@direct.bostonchildrens.org

Organizations & group practices 6

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1417214107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002",
            "telephone_number": "617-573-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-573-3412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave North",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01655",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GISE",
        "first_name": "RYAN",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "265093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.