Individual provider Active NPI

Mary Ellen Ryan, FNP

  • Family Nurse Practitioner
  • Yonkers, NY
National Provider Identifier
1003108747
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336650-1 Issued in NY
Practice address
919 Bdway
Yonkers, NY 10701-1206
Phone
(914) 968-1900
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336650-1 NY Primary

Addresses

Primary practice location

919 Bdway
Yonkers, NY 10701-1206

Mailing address

204 Mallard Way
Peekskill, NY 10566-4173
Phone (914) 734-9542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011002525 NY Practitioner - Nurse Practitioner 1052609864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nysarc, Inc Ulster, Greene, Putnam Counties ChapterGroup PAC ID 2466543764, 10 clinicians

Practice addresses (Care Compare)

139 Cornell St
Kingston, NY 12401-3633
Phone (845) 331-4300

471 Albany Ave
Kingston, NY 12401-2138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F336650-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. Ulster, Greene, Putnam Counties Chapter CurrentSince Apr 1, 2025 Accepting new patients
Richmond Children'S Center, Inc. Past Accepting new patients
Hudson Valley Health Specialties, Inc Past Accepting new patients
Maple Medical, LLP Past Accepting new patients

Locations

1938 Route 6
Carmel, NY 10512
Phone (845) 225-5650

139 Cornell St
Kingston, NY 12401
Phone (845) 331-4300

471 Albany Ave
Kingston, NY 12401
Phone (845) 331-4300

Organizations & group practices 4

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1003108747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MALLARD WAY",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105664173",
            "telephone_number": "914-734-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 BDWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011206",
            "telephone_number": "914-968-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARY ELLEN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336650-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.