Ryan Imelio
Individual provider Active NPI Physician Assistant · Oxford, MA
NPI 1508634775 · NPPES record last updated Nov 3, 2025
Key facts
- NPI
- 1508634775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 78 Sutton Ave
Oxford, MA 01540-1813 - Phone
- (508) 499-1760
- Fax
- (508) 449-1757
- NPI assigned
- Dec 18, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Umass Memorial Medical Group Inc
Practice addresses (Care Compare)
78 Sutton Ave
Oxford, MA 01540-1813
Phone (508) 499-1760
Hospital & facility affiliations
- Umass Memorial Health - Harrington Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251117001054 | MA | Practitioner - Physician Assistant | 2769973890 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group, Inc. | Current |
Accepting new patients | |
| Umass Memorial Medical Group Inc | Physician Assistant | Current |
Accepting new patients |
Locations
78 Sutton Ave
Oxford, MA 01540
Phone (508) 499-1760
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
78 Sutton Ave
Oxford, MA 01540-1813
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Other providers in Oxford, MA
- Jeanne Hampton
- Harrington Physician Services, Inc.
- Juliana Hernandez
- Christina Dawn Higgins
- Becky Marie Howard
- Inner Peace Counseling
- Madeline Intravia
- Kimberly Jaksina
- Janny Transportation Services Inc
- K-S Personal Transport, Inc
All providers in Oxford, MA · Physician Assistant in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.