Active NPI
Ryan C Jay, DO
- Dermatology Physician
- Scarborough, ME
National Provider Identifier
1043960677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- DO4259
- Practice address
- 71 US Route 1 Ste J
Scarborough, ME 04074-7168 - Phone
- (207) 770-5621
- Fax
- (207) 203-4875
- NPI assigned
- Mar 26, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | DO4259 | ME | Primary |
Addresses
Primary practice location
71 US Route 1 Ste J
Scarborough, ME 04074-7168
Mailing address
111 New Hampshire Ave Ste 2
Portsmouth, NH 03801-2864
Phone (330) 947-6021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220526000308 | OH | Order and Referring Only - Internal Medicine | 7517345952 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO4259 | ME | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780358400000",
"number": "1043960677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NEW HAMPSHIRE AVE STE 2",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038012864",
"telephone_number": "330-947-6021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 US ROUTE 1 STE J",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040747168",
"telephone_number": "207-770-5621",
"fax_number": "207-203-4875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAY",
"first_name": "RYAN",
"middle_name": "C",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-26",
"last_updated": "2026-06-02",
"certification_date": "2026-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "ME",
"license": "DO4259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.