SONNLY RIBOURG (PA) – Physician Assistant, NPI 1154739241

SONNLY RIBOURG (PA) is a healthcare provider. based in Malden, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 5114 (MA). The NPI Number for SONNLY RIBOURG (PA) is 1154739241

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
SONNLY RIBOURG (PA)
NPI
1154739241
Phone
(781) 338-0500
Address
195 CANAL ST
Enumeration Date
1 August 2014
Last Update Date
24 August 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7813380500
Graduation Year
2014 (12 years ago)
PAC ID
4587955265
Group Practice PAC ID
8921910894
Professional Enrollment ID
I20160628001181
Address ID
MA021486701MA195XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

5,091 PHYSICIAN ASSISTANT in MA

Provider Addresses for SONNLY RIBOURG (PA)

  • 195 CANAL ST

    MALDEN, MA 021486701

    Phone: (781) 338-0500

    Type: Location

  • 158 HANCOCK ST

    APT 1

    EVERETT, MA 021491333

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-06-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160628001181IPhysician AssistantMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4737$0
99442Telephone medical discussion with physician, 11-20 minutes3028$0
View full utilization report →

Insurance plans in this area (ZIP 02148)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910894View full group profile
NameSpecialtyState
Family PracticeMA
-MA
-NH
Rheumatology, Internal MedicineMA
-MA
Emergency MedicineMA
Family PracticeMA
O B S T E T R I C S/ G Y N E C O L O G YPA
Emergency MedicineMA
Physician AssistantMA

Reviews

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Frequently asked questions

Does SONNLY RIBOURG (PA) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — SONNLY RIBOURG (PA) uses 1154739241.
Can I rely on SONNLY RIBOURG (PA) being an active provider?
As of the registry snapshot, SONNLY RIBOURG (PA) is marked active.
What is SONNLY RIBOURG (PA)'s primary classification?
Physician Assistant is the headline specialty for SONNLY RIBOURG (PA) here. Clinical services aligned with this taxonomy classification.
Where should I expect SONNLY RIBOURG (PA) on a map?
Expect Malden, Massachusetts as a primary anchor for SONNLY RIBOURG (PA) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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