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Individual provider Active NPI

Ryan Michael McHenry, DO

  • Family Medicine Physician
  • Eureka, CA
National Provider Identifier
1023685625
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A21050 Issued in CA
Practice address
2280 Harrison Ave Ste B
Eureka, CA 95501-3200
Phone
(707) 443-9371
Fax
(707) 683-3089
NPI assigned
Jun 10, 2021
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A21050 CA Primary

Addresses

Primary practice location

2280 Harrison Ave Ste B
Eureka, CA 95501-3200

Mailing address

2280 Harrison Ave Ste B
Eureka, CA 95501-3200
Phone (707) 443-9371

Other practice location 1

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000472 CA Practitioner - Family Practice 9335590942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

2280 Harrison Ave
Suite B
Eureka, CA 95501-3200
Phone (707) 443-9371

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions14
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21050CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Jun 10, 2024 Accepting new patients
Providence Medical Foundation CurrentSince Jun 10, 2024 Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

2280 Harrison Ave
Ste B
Eureka, CA 95501
Phone (707) 443-9371

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1023685625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 HARRISON AVE STE B",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013200",
            "telephone_number": "707-443-9371",
            "fax_number": "707-683-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 HARRISON AVE STE B",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013200",
            "telephone_number": "707-443-9371",
            "fax_number": "707-683-3089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Dolbeer St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955014736",
            "country_code": "US",
            "telephone_number": "707-445-8121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCHENRY",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.