Paul Kirkpatrick Reardon

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

1016668 Issued in MA

Practice address

55 Fruit St
Boston, MA 02114-2696

Phone

(617) 642-6832

NPI assigned

Apr 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Psychiatry

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Mass General Brigham Medical Group Northern Massachusetts IncGroup PAC ID 3577467224, 817 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
• North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment Care Compare group NPD
• Mass General Brigham Medical Group Northern Massachusetts Inc

  • Emergency Medicine Physician
  • Salem, MA
  • NPI 1588606123
  Medicare reassignment Care Compare group NPD
• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Medicare reassignment NPD
• The Center for Cognition and Character PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cambridge, MA
  • NPI 1528957685
  NPD Authorized official

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

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1477132090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "WANG 812",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021147154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-642-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "PAUL",
        "middle_name": "KIRKPATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "1016668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Allen Reardon
• Gabriella Reardon, RPH
• Jeffrey Brian Reardon, D.M.D.
• Martha Reardon, RN, WHNP-BC
• McCauley Grace Reardon, DMD
• Rachel Reardon, MD
• Allison Taylor Cook Reaves, M.D.
• Rebecca D. Forkner, PH.D., LLC
• Rebecca Eddy Muccilli Psy.D., LLC
• Rebecca Girard Clinical Social Work

• Psychiatry Physician in Boston, MA
• Providers in Boston, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.

Verify at the official NPI Registry.