Ronald Harold Boardway, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

RB008826 Issued in MI

Practice address

19900 E 10 Mile Rd Ste 102
Saint Clair Shores, MI 48080-4412

Phone

(586) 776-3666

Fax

(586) 776-3369

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Psychologist

Education

Wayne State University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associated Psychologists PLCGroup PAC ID 5799827218, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Associated Psychologists PLC

  • Clinical Psychologist
  • Saint Clair Shores, MI
  • NPI 1629112420
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1881703858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19900 E 10 MILE RD STE 102",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804412",
            "telephone_number": "586-776-3666",
            "fax_number": "586-776-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 E 10 MILE RD STE 102",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804412",
            "telephone_number": "586-776-3666",
            "fax_number": "586-776-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDWAY",
        "first_name": "RONALD",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "RB008826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.