NPIMap

Individual provider Active NPI

Ryan Tai, M.D.

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1902192420
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
365324 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3850
Fax
(508) 856-1860
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP02297 RI
Diagnostic Radiology Physician 2085R0202X 365324 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-0224

Other identifiers 1

IdentifierTypeStateIssuer
110113783AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mtai48120@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160726002756 MA Practitioner - Diagnostic Radiology 6305084633 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Warren Alpert Medical School of Brown University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP02297RIMDInternal Medicine Physician
365324MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shields Health at Umass Memorial Health - Milford Regional Medical CurrentSince Dec 1, 2025 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 17, 2017 Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince May 1, 2021 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Jul 17, 2017 Accepting new patients
Umass Memorial MRI - Marlborough CurrentSince Jul 17, 2017 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince May 1, 2021 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Jan 29, 2019 Accepting new patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Umass Memorial MRI & Imaging Center LLC CurrentSince Jul 17, 2017 Accepting new patients
Shields Health at Umass Memorial Health - Milford Regional Medical CurrentSince Dec 1, 2025 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

157 Union St
Marlborough, MA 01752
Phone (508) 481-5000

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

10 Little Brook Rd
West Wareham, MA 02576

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: mtai48120@umassmemorial.direct-ci.com

Organizations & group practices 11

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 7

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1902192420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850",
            "fax_number": "508-856-1860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Union St",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017521228",
            "country_code": "US",
            "telephone_number": "508-486-0224",
            "fax_number": "508-229-1241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAI",
        "first_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP02297",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "365324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110113783A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtai48120@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.