Individual provider Active NPI

Ryan McGovern, FNP-BC

  • Family Nurse Practitioner
  • Cambridge, MA
National Provider Identifier
1679925291
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2299435 Issued in MA
Practice address
75 Mount Auburn St
Cambridge, MA 02138-4960
Phone
(617) 495-5711
NPI assigned
Jul 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN01409 RI
Family Nurse Practitioner 363LF0000X RN2299435 MA Primary

Addresses

Primary practice location

75 Mount Auburn St
Cambridge, MA 02138-4960

Mailing address

75 Mount Auburn St
Cambridge, MA 02138-4960
Phone (617) 495-5711

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161025000502 MA Practitioner - Nurse Practitioner 6901184019 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Lifestyle Medical and Cardiovascular Associates PCGroup PAC ID 0941611016, 7 clinicians

Practice addresses (Care Compare)

112 Worcester St
Suite 303
Wellesley, MA 02481-3632
Phone (617) 916-9433

Hospital & facility affiliations

  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2299435MAMDFamily Nurse Practitioner
APRN01409RIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
President and Fellows of Harvard College CurrentSince Jul 10, 2023 Accepting new patients
President & Fellows of Harvard College CurrentSince Jul 10, 2023 Accepting new patients
Milford Regional Physician Group, Inc. CurrentSince Apr 20, 2020 Accepting new patients
Lifestyle Medical and Cardiovascular Associates PC CurrentSince Jun 2, 2025 Accepting new patients
Milford Regional Physician Group, Inc. CurrentSince Apr 20, 2020 Accepting new patients
C&S Anesthesia LLC PastSince May 1, 2021 Accepting new patients

Locations

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

1280 W Central St
Ste 101
Franklin, MA 02038
Phone (508) 471-1480

68A Main St
Ste 101
Medway, MA 02053
Phone (508) 533-6020

9 Industrial Rd
Ste 5
Milford, MA 01757
Phone (508) 473-1480

100 Medway Rd
Ste 401
Milford, MA 01757
Phone (508) 634-7338

100 Commerce Dr
Northbridge, MA 01534
Phone (508) 234-6311

112 Worcester St
Ste 303
Wellesley Hills, MA 02481
Phone (617) 916-9433

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1679925291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "RYAN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN01409",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2299435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.