Individual provider Active NPI

Ryan Brewster

  • Pediatrics Physician
  • Cambridge, MA
National Provider Identifier
1982282125
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1019622 Issued in MA
Practice address
1493 Cambridge St
Cambridge, MA 02139-1099
Phone
(617) 665-1000
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 1019622 MA Primary

Addresses

Primary practice location

1493 Cambridge St
Cambridge, MA 02139-1099

Mailing address

300 Longwood Ave
Department of Medicine - Hunn 2
Boston, MA 02115

Other practice location 1

1 Boston Medical Ctr Pl
Boston, MA 02118-2908
Phone (978) 314-0836

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
I20210805003285 MA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4082018528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1019622MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

Interoperability endpoints

  • Direct secure messaging: rbrewster441304@direct.bilh.masshiway.net
  • Direct secure messaging: rbrewster121532@direct.challiance.masshiway.net
  • Direct secure messaging: rbrewster28530@direct.bostonchildrens.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1982282125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "DEPARTMENT OF MEDICINE - HUNN 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391099",
            "telephone_number": "617-665-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boston Medical Ctr Pl",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182908",
            "country_code": "US",
            "telephone_number": "978-314-0836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWSTER",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1019622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.