Individual provider Active NPI

Ryan W Ahern, MD

  • Procedural Dermatology Physician
  • College Station, TX
National Provider Identifier
1003033838
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
M6002 Issued in TX
Practice address
1651 Rock Prairie Rd Ste 103
College Station, TX 77845-8652
Phone
(979) 314-5400
Fax
(979) 703-1040
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X M6002 TX
Procedural Dermatology Physician 207NS0135X M6002 TX Primary

Addresses

Primary practice location

1651 Rock Prairie Rd Ste 103
College Station, TX 77845-8652

Mailing address

1651 Rock Prairie Rd Ste 103
College Station, TX 77845-8652
Phone (979) 314-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070801000350 TX Practitioner - Dermatology 7517927288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1651 Rock Prairie Rd
Suite 103
College Station, TX 77845-8652
Phone (979) 314-5400

Merit-based Incentive Payment System (MIPS)

Final score
94.17 of 100Reported as individual
Quality
88.33
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision25
Removal of skin lesions73
Removal of skin cancer790
Skin biopsy27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Procedural Dermatology PLLC Mohs-Micrographic Surgery CurrentSince Nov 18, 2019 Accepting new patients

Networks

  • NM HMO C-SNP
  • TX HMO D-SNP
  • TX HMO

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIHHAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1003033838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 ROCK PRAIRIE RD STE 103",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458652",
            "telephone_number": "979-314-5400",
            "fax_number": "979-703-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 ROCK PRAIRIE RD STE 103",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458652",
            "telephone_number": "979-314-5400",
            "fax_number": "979-703-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHERN",
        "first_name": "RYAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "M6002",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TX",
            "license": "M6002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.