Individual provider Active NPI

Kristen Marie Ryan

  • Gerontology Nurse Practitioner
  • Newburyport, MA
National Provider Identifier
1710439849
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN2279223 Issued in MA
Practice address
28 Green St
Newburyport, MA 01950-2650
Phone
(978) 465-7719
Fax
(978) 465-1516
NPI assigned
Oct 24, 2016
Last updated
Oct 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN2279223 MA Primary

Addresses

Primary practice location

28 Green St
Newburyport, MA 01950-2650

Mailing address

28 Green St
Newburyport, MA 01950-2650
Phone (978) 465-7719

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
I20161221000694 MA Practitioner - Nurse Practitioner 0042591554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2000 Washington St
Blue BLDG Suite 304 Rheumatology
Newton, MA 02462-1650
Phone (617) 243-5440

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Feb 12, 2018 Accepting new patients
Newton Wellesley Hospital Current Accepting new patients
River Valley Infectious Disease Specialists Inc. Past Accepting new patients

Locations

2000 Washington St
Ste 304
Newton Lower Falls, MA 02462
Phone (617) 243-5440

2000 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

Interoperability endpoints

  • Direct secure messaging: ryan.kristen.nwh@direct.partners.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1710439849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 GREEN ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502650",
            "telephone_number": "978-465-7719",
            "fax_number": "978-465-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 GREEN ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502650",
            "telephone_number": "978-465-7719",
            "fax_number": "978-465-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2279223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

Verify at the official NPI Registry.