Active NPI
Ryan Koehn, PA-C
- Physician Assistant
- New Port Richey, FL
National Provider Identifier
1114270675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 9106743
- Practice address
- 5534 Gulf Dr
New Port Richey, FL 34652-4000 - Phone
- (727) 847-3992
- Fax
- (727) 848-1118
- NPI assigned
- Oct 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9106743 | FL | Primary |
Addresses
Primary practice location
5534 Gulf Dr
New Port Richey, FL 34652-4000
Mailing address
5534 Gulf Dr Ste 1
New Port Richey, FL 34652-4000
Phone (847) 553-6432
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5534 Gulf Dr
New Port Richey, FL 34652-4000
Phone (727) 847-3992
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9106743 | FL | MD | Physician Assistant |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 1
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.
-
- MOHS-Micrographic Surgery Physician
- New Port Richey, FL
- NPI 1275522054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554422400000",
"number": "1114270675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5534 GULF DR STE 1",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346524000",
"telephone_number": "847-553-6432",
"fax_number": "727-848-1118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5534 GULF DR",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346524000",
"telephone_number": "727-847-3992",
"fax_number": "727-848-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEHN",
"first_name": "RYAN",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-22",
"last_updated": "2019-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 9106743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Port Richey, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.
- 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.