Individual provider Active NPI

Ronnie Barboza

  • Acute Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1770171142
Registry record updated Oct 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2337892 Issued in MA
Practice address
36 1St Ave
Boston, MA 02129-4557
Phone
(774) 240-4088
NPI assigned
Jan 1, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2337892 MA Primary

Addresses

Primary practice location

36 1St Ave
Boston, MA 02129-4557

Mailing address

1402 Rock Wood Dr
Saugus, MA 01906-4537
Phone (774) 240-4088

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
I20251110001594 MA Practitioner - Nurse Practitioner 8628430378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

200 Mill Rd
Suite 190
Fairhaven, MA 02719-5259
Phone (508) 973-0857

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2337892MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Aug 31, 2025 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 31, 2025 Accepting new patients

Locations

200 Mill Rd
Ste 190
Fairhaven, MA 02719
Phone (508) 973-0857

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

Interoperability endpoints

  • Direct secure messaging: rbarboza@landmarkhealth-direct.org
  • Direct secure messaging: rbarboza67718@direct.southcoast.org

Organizations & group practices 2

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 1

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": "1609459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634428800000",
    "number": "1770171142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 ROCK WOOD DR",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019064537",
            "telephone_number": "774-240-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 1ST AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021294557",
            "telephone_number": "774-240-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOZA",
        "first_name": "RONNIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-01",
        "last_updated": "2021-10-17",
        "certification_date": "2021-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "2337892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.