Individual provider Active NPI

Jill Ryan, PA

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1033143607
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65438 Issued in CA
Practice address
1501 Westcliff Dr Ste 201
Newport Beach, CA 92660-5518
Phone
(440) 387-3114
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0182 NH
Physician Assistant 363A00000X PA65438 CA Primary

Addresses

Primary practice location

1501 Westcliff Dr Ste 201
Newport Beach, CA 92660-5518

Mailing address

1501 Westcliff Dr Ste 201
Newport Beach, CA 92660-5518
Phone (440) 387-3114

Other identifiers 1

IdentifierTypeStateIssuer
30009568MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080416000096 NH Practitioner - Physician Assistant 9032296660 Reassigns benefits to 2 organizations
I20260625000645 MA Practitioner - Physician Assistant 9032296660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

399 Revolution Dr
Somerville, MA 02145-1484

399 Revolution Dr
Suite 458
Somerville, MA 02145-1444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0182NHMDSpeech-Language Assistant
PA65438CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 9, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jan 11, 2001 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 9, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jan 11, 2001 Accepting new patients
MW Wellness Ventures I, LLC Past Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

Interoperability endpoints

  • Direct secure messaging: jryan16164@direct.dartmouth-hitchcock.org
  • Direct secure messaging: jill.ryan@601888261275652.direct.elationemr.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1033143607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 WESTCLIFF DR STE 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605518",
            "telephone_number": "440-387-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 WESTCLIFF DR STE 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605518",
            "telephone_number": "440-387-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JILL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0182",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30009568",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.