DR. RONALD HAROLD BOARDWAY (PHD) – Clinical Psychologist, NPI 1881703858

DR. RONALD HAROLD BOARDWAY (PHD) is a healthcare provider. based in Saint clair shores, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. RB008826 (MI). The NPI Number for DR. RONALD HAROLD BOARDWAY (PHD) is 1881703858

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. RONALD HAROLD BOARDWAY (PHD)
NPI
1881703858
Phone
(586) 776-3666
Address
19900 E 10 MILE RD STE 102
Enumeration Date
30 August 2006
Last Update Date
5 June 2019

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5867763366
Graduation Year
1994 (32 years ago)
PAC ID
3971645409
Group Practice PAC ID
5799827218
Professional Enrollment ID
I20120614000605
Address ID
MI480804412SA19900RDXX501
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,225 CLINICAL PSYCHOLOGIST in MI

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Provider Addresses for DR. RONALD HAROLD BOARDWAY (PHD)

  • East 10 Mile Road, Saint Clair Shores, Macomb County, Michigan, 48080, United States

    SAINT CLAIR SHORES, MI 480804412

    Phone: (586) 776-3666

    Fax: (586) 776-3369

    Mailing address matches the actual address.

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: 2012-06-14

PECOS data refreshed: 2026-06-15

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
I20120614000605IClinical PsychologistMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48080)

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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: 5799827218View full group profile
NameSpecialtyState
Clinical PsychologistMI
Clinical PsychologistMI
-MI
Clinical PsychologistMI
Clinical Social WorkerCA
Mental Health CounselorMI

Reviews

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Frequently asked questions

How do payers reference DR. RONALD HAROLD BOARDWAY (PHD)?
For DR. RONALD HAROLD BOARDWAY (PHD), use NPI 1881703858 as the unique 10-digit identifier.
Active or inactive — what applies to DR. RONALD HAROLD BOARDWAY (PHD)?
You should see DR. RONALD HAROLD BOARDWAY (PHD) as active in CMS-hosted NPPES data.
What clinical focus is listed for DR. RONALD HAROLD BOARDWAY (PHD)?
At a glance, DR. RONALD HAROLD BOARDWAY (PHD) is tied to Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is DR. RONALD HAROLD BOARDWAY (PHD) located near Saint Clair Shores?
DR. RONALD HAROLD BOARDWAY (PHD) currently maps to Saint Clair Shores, Michigan in this extract.
Can I trust this NPI listing for DR. RONALD HAROLD BOARDWAY (PHD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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