Individual provider Active NPI

Edward A Ryan, MD

  • Ophthalmology Physician
  • Winchester, MA
National Provider Identifier
1083613186
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
71171 Issued in MA
Practice address
955 Main St
Ste 108
Winchester, MA 01890-1961
Phone
(787) 721-0447
Fax
(781) 721-2250
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 71171 MA Primary

Addresses

Primary practice location

955 Main St
Ste 108
Winchester, MA 01890-1961

Mailing address

340 Main St
Ste. 670
Worcester, MA 01608-1604
Phone (508) 754-3566

Other identifiers 1

IdentifierTypeStateIssuer
2019191MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72251MAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Microsurgical Eye Consultants Ophthalmology Past Accepting new patients
East Florida Eye Institute PA Past Accepting new patients
Eyesight Ophthalmic Services PLLC Ophthalmology PastSince Jan 26, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ryan.edward@elincdirect.org

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1083613186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAIN ST",
            "address_2": "STE. 670",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081604",
            "telephone_number": "508-754-3566",
            "fax_number": "508-438-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "address_2": "STE 108",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901961",
            "telephone_number": "787-721-0447",
            "fax_number": "781-721-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "71171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019191",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

Verify at the official NPI Registry.