Individual provider Active NPI

Ryan Frieder, D.O.

  • Anesthesiology Physician
  • Tucson, AZ
National Provider Identifier
1083750509
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
006358 Issued in AZ
Practice address
3390 N. Campbell Ave.
Suite #110
Tucson, AZ 85719-2380
Phone
(520) 795-7650
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 006358 AZ Primary
General Practice Physician 208D00000X 200300978 NC

Addresses

Primary practice location

3390 N. Campbell Ave.
Suite #110
Tucson, AZ 85719-2380

Mailing address

5712 N Placita Arizpe
Tucson, AZ 85718-4638
Phone (505) 919-9661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215001729 ID Practitioner - Anesthesiology 5890819072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alphonsus Professional Medical Services LLCGroup PAC ID 7214849751, 124 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2152

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006358AZMDAnesthesiology Physician
200300978NCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alphonsus Professional Medical Services LLC Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients
Boise Anesthesia, PA Anesthesiology CurrentSince Dec 6, 2022 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Nov 1, 2023 Accepting new patients
Boise Anesthesia, P a Anesthesiology CurrentSince Dec 6, 2022 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

Interoperability endpoints

  • Direct secure messaging: rfrieder2372815@direct.trinity-health.org

Organizations & group practices 4

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 5

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1083750509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5712 N PLACITA ARIZPE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857184638",
            "telephone_number": "505-919-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 N. CAMPBELL AVE.",
            "address_2": "SUITE #110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDER",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "006358",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "200300978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.