Individual provider Active NPI

Ryan Gordon Moyer, DR

  • Physical Therapist
  • West Lawn, PA
National Provider Identifier
1073407466
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
TPT023983 Issued in PA
Practice address
2211 Quarry Dr Ste E55
West Lawn, PA 19609-1162
Phone
(610) 860-5500
NPI assigned
Jun 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X TPT023983 PA Primary

Addresses

Primary practice location

2211 Quarry Dr Ste E55
West Lawn, PA 19609-1162

Mailing address

495 N Claude a Lord Blvd
Pottsville, PA 17901-2705
Phone (570) 516-9858

Other practice location 1

495 N Claude A Lord Blvd
Pottsville, PA 17901-2705
Phone (570) 516-9858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903002937 PA Practitioner - Physical Therapist in Private Practice 3577065291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

495 N Claude a Lord Blvd
Pottsville, PA 17901-2705
Phone (570) 516-9858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPT023983PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group, P.C. CurrentSince Aug 18, 2025 Accepting new patients
Integrated Medical Group P C CurrentSince Aug 18, 2025 Accepting new patients
Img PT Physical Therapist Past Accepting new patients

Locations

495 N Claude a Lord Blvd
Pottsville, PA 17901
Phone (570) 516-9858

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

2211 Quarry Dr
Ste E55
West Lawn, PA 19609
Phone (570) 516-9858

Interoperability endpoints

  • Direct secure messaging: rmoyer@imgpc.medentdirect.com

Organizations & group practices 3

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": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1073407466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012705",
            "telephone_number": "570-516-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 QUARRY DR STE E55",
            "city": "WEST LAWN",
            "state": "PA",
            "postal_code": "196091162",
            "telephone_number": "610-860-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 N Claude A Lord Blvd",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179012705",
            "country_code": "US",
            "telephone_number": "570-516-9858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYER",
        "first_name": "RYAN",
        "middle_name": "GORDON",
        "credential": "DR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "TPT023983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lawn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.