Individual provider Active NPI

Ryan Macdonough

  • Clinical Social Worker
  • East Hartford, CT
National Provider Identifier
1639546005
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9212 Issued in CT
Practice address
281 Main St
East Hartford, CT 06118-1823
Phone
(860) 291-1309
Fax
(860) 291-1396
NPI assigned
Sep 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9212 CT Primary

Addresses

Primary practice location

281 Main St
East Hartford, CT 06118-1823

Mailing address

281 Main St
East Hartford, CT 06118-1823
Phone (860) 291-1309

Other identifiers 1

IdentifierTypeStateIssuer
004050993MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151105000167 CT Practitioner - Clinical Social Worker 9436469335 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Hospital and Medical Center CurrentSince May 27, 2018 Accepting new patients
Saint Francis Hospital and Medical Center CurrentSince May 27, 2018 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 20, 2025 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 20, 2025 Accepting new patients
Intercommunity, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Intercommunity, Inc. CurrentSince Sep 1, 2015 Accepting new patients

Locations

281 Main St
East Hartford, CT 06118
Phone (860) 291-1335

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

800 Connecticut Blvd
Fl 4
Hartford, CT 06108
Phone (860) 622-5451

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1639546005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181823",
            "telephone_number": "860-291-1309",
            "fax_number": "860-291-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181823",
            "telephone_number": "860-291-1309",
            "fax_number": "860-291-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONOUGH",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004050993",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.