Joseph Vincent Ryan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

701 Issued in AZ

Practice address

4502 E Oak St
At Costco
Phoenix, AZ 85008-2411

Phone

(602) 508-1689

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 2, 2015 through Jul 2, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104947431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 E PARK AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852346362",
            "telephone_number": "602-508-1689",
            "fax_number": "602-952-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E OAK ST",
            "address_2": "AT COSTCO",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850082411",
            "telephone_number": "602-508-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JOSEPH",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "60110",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cierra Kristine Ryan, PA-C
• Denita Ryan, ANP
• Dennis Martin Ryan, LPC
• Eileen Ryan, SLP
• Hannah Ryan, OTD
• Lettie Lerina-Annette Ryan, FNP-C
• Lily Nan Ryan, MS
• Nettie Ryan, RN
• Peter T Ryan, OD
• Rochelle Ryan, LAC

• Optometrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.