Tiffany Enola Ryder, PA-S

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0011625 Issued in DE

Practice address

640 S State St
Dover, DE 19901-3530

Phone

(302) 744-6156

Fax

(302) 735-3845

NPI assigned

Feb 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Chester River Hospital Center

  dba University of Maryland Shore Medical Center at Chestertown

  • General Acute Care Hospital
  • Chestertown, MD
  • NPI 1679536809
  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC, MD

  Medicare reassignment NPD
• Privia Care Center LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1164874426

  MD

  Medicare reassignment
• Upper Chesapeake Emergency Medicine Physicians, LLC

  • Emergency Medicine Physician
  • Bel Air, MD
  • NPI 1285854026
  Medicare reassignment
• Urgent Care Medicine, LLC

  dba AFC Urgent Care Edgewater

  • Urgent Care Clinic/Center
  • Edgewater, MD
  • NPI 1174804918
  Medicare reassignment
• Menocal Medical Services PA

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1083795918
  NPD
• Privia Care Center LLC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1730664012
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1063913515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-744-6156",
            "fax_number": "302-735-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "TIFFANY",
        "middle_name": "ENOLA",
        "name_prefix": "Ms.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian John Ruth, PA-C
• Shannon R Rutland, RN
• Rxpathway LLC
• Kelly Ryan, APRN, FNP-C
• Tristan Rybicki
• Kimberly Sabanayagam, LCSW
• Audra Marie Josephine Sadler
• Devon Carl Sadlowski, DMD
• Sage Mental Healthcare LLC
• Or Sagi, MD

• Physician Assistant in Dover, DE
• Providers in Dover, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.

Verify at the official NPI Registry.