Active NPI
Ryan Gazzola, PH.D
- Psychologist
- Cambridge, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 9890
- Practice address
- 872 Massachusetts Ave.
Ste. 2-2, 2-7
Cambridge, MA 02139 - Phone
- (617) 395-5806
- NPI assigned
- May 17, 2007
- Last updated
- Mar 3, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | ||
| Psychologist | 103T00000X | 9890 | MA | Primary |
Addresses
Primary practice location
872 Massachusetts Ave.
Ste. 2-2, 2-7
Cambridge, MA 02139
Mailing address
1000 Jefferson St.
Suite 2C
Lynchburg, VA 24504
Phone (617) 379-0496
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11 River St
Wellesley, MA 02481-2098
Phone (781) 431-1177
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9890 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boodah, Inc | Psychologist | Current | Accepting new patients |
| Colony Care Inc | Current | Accepting new patients | |
| Thrive Counseling LLC | Past | Accepting new patients | |
| Northeast Hospital Corporation | Past | Accepting new patients |
Locations
161 Summer St
Ste 5
Kingston, MA 02364
Phone (781) 516-7817
50 Main St
Ste 201
North Reading, MA 01864
Phone (781) 287-8676
32 Court St
Ste 7
Plymouth, MA 02360
Phone (774) 426-7707
11 River St
Wellesley Hills, MA 02481
Phone (781) 237-7979
11 River St
Ste 1
Wellesley Hls, MA 02481
Phone (508) 695-7447
Interoperability endpoints
- ryan.gazzola.1@28623.direct.athenahealth.com
Organizations & group practices 4
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.
-
dba Colony Care Behavioral Health
- Mental Health Counselor
- Wellesley, MA
- NPI 1720053408
-
dba Mindful Paths Psychological Testing
- Clinical Psychologist
- Plymouth, MA
- NPI 1104390525
-
- Psychiatric Hospital Unit
- Beverly, MA
- NPI 1407827710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425340800000",
"number": "1477760775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 JEFFERSON ST.",
"address_2": "SUITE 2C",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "24504",
"telephone_number": "617-379-0496",
"fax_number": "617-807-0958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "872 MASSACHUSETTS AVE.",
"address_2": "STE. 2-2, 2-7",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02139",
"telephone_number": "617-395-5806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAZZOLA",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2015-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "9890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.