Active NPI
Jennifer Ryan, D.O.
- Family Medicine Physician
- Gardner, MA
National Provider Identifier
1467427708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 214124
- Practice address
- 57 City Hall Ave
Gardner, MA 01440-2614 - Phone
- (978) 630-3862
- Fax
- (978) 630-4176
- NPI assigned
- Feb 21, 2006
- Last updated
- Nov 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 214124 | MA | Primary |
Addresses
Primary practice location
57 City Hall Ave
Gardner, MA 01440-2614
Mailing address
57 City Hall Ave
Gardner, MA 01440-2614
Phone (978) 630-3862
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0178241 | Medicaid | 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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of New England, College of Osteo Medicine, 1999
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
57 City Hall Ave
Gardner, MA 01440-2614
Phone (978) 630-3862
Hospital & facility affiliations
- Care Central Vna & Hospice Inc
- Caretenders
- Vna Care Network
- Heywood Hospital -
- Athol Memorial Hospital
- Umass Memorial Medical Center/University Campus
- Umass Memorial Healthalliance Hospitals
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 82.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214124 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gardner Family Medicine, Inc. | Family Medicine | Current | Accepting new patients |
| Prime Foot and Ankle Care, LLC | Past | Accepting new patients |
Locations
57 City Hall Ave
Gardner, MA 01440
Phone (978) 630-3862
Interoperability endpoints
- https://api.platform.athenahealth.com/1039/brand/1/csg/1/fhir/r4
- jennifer.ryan.1@1039.direct.athenahealth.com
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.
-
- Foot & Ankle Surgery Podiatrist
- Chelmsford, MA
- NPI 1093253700
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Athol, MA
- NPI 1336120047
-
- Home Health Agency
- Gardner, MA
- NPI 1477526705
-
dba Heywood Hospital
- General Acute Care Hospital
- Gardner, MA
- NPI 1205823879
-
- General Acute Care Hospital
- Leominster, MA
- NPI 1013995133
-
- Psychiatric Hospital Unit
- Clinton, MA
- NPI 1285171934
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
-
- Home Health Agency
- Worcester, MA
- NPI 1922002286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1467427708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 CITY HALL AVE",
"city": "GARDNER",
"state": "MA",
"postal_code": "014402614",
"telephone_number": "978-630-3862",
"fax_number": "978-630-4176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 CITY HALL AVE",
"city": "GARDNER",
"state": "MA",
"postal_code": "014402614",
"telephone_number": "978-630-3862",
"fax_number": "978-630-4176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "JENNIFER",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-21",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "214124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0178241",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gardner, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.