Individual provider Active NPI

Ronald S Tadiri, MD

  • Pediatrics Physician
  • Holden, MA
National Provider Identifier
1780645663
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60624 Issued in MA
Practice address
64 Boyden Rd
Holden, MA 01520
Phone
(508) 885-2003
Fax
(508) 885-8071
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60624 MA Primary

Addresses

Primary practice location

64 Boyden Rd
Holden, MA 01520

Mailing address

64 Boyden Rd
Holden, MA 01520-2570
Phone (508) 885-2003

Other identifiers 17

IdentifierTypeStateIssuer
042472266OtherPRIVATE HEALTHCARE SYSTEM
9900823OtherFALLON COMMUNITY HEALTH P
784244OtherMVP HEALTH CARE
9602726OtherCIGNA HEALTH PLAN
J11038OtherBLUE SHIELD HMO BLUE
AA1181OtherHARVARD PILGRIM HEALTHCAR
33867OtherCHILDRENS MEDICAL SECURIT
935033OtherFIRST HEALTH
J11038OtherBLUE CARE ELECT
J11038OtherBLUE SHIELD INDEMNITY
110050631AMedicaidMA
043058466OtherHEALTHCARE VALUE MANAGEME
3085686OtherWELFARE
042472266OtherONE HEALTH PLAN
33867OtherHEALTHY START
042472266OtherTHREE RIVERS
5576020OtherAETNA US HEALTHCARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000406 MA Practitioner - Pediatric Medicine 4880634385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60624MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Pediatrics CurrentSince Jan 18, 2010 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

64 Boyden Rd
Holden, MA 01520
Phone (508) 829-6765

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

630 Plantation St
Fl ST12
Worcester, MA 01605
Phone (774) 261-1356

Interoperability endpoints

  • Direct secure messaging: ronald.tadiri.npi1780645663.reliant@direct.optumcare.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1780645663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BOYDEN RD",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015202570",
            "telephone_number": "508-885-2003",
            "fax_number": "508-885-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BOYDEN RD",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "01520",
            "telephone_number": "508-885-2003",
            "fax_number": "508-885-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADIRI",
        "first_name": "RONALD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "60624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH P",
            "identifier": "9900823",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "784244",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "9602726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "J11038",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA1181",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MEDICAL SECURIT",
            "identifier": "33867",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "935033",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "J11038",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "J11038",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110050631A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE VALUE MANAGEME",
            "identifier": "043058466",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELFARE",
            "identifier": "3085686",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY START",
            "identifier": "33867",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "5576020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holden, MA

Sources for this page

Verify at the official NPI Registry.