Individual provider Active NPI

Ryan Cantos

  • Family Nurse Practitioner
  • Ventura, CA
National Provider Identifier
1114703188
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027027 Issued in CA
Practice address
2772 Johnson Dr Ste 114
Ventura, CA 93003-7261
Phone
(805) 644-3311
Fax
(805) 644-2161
NPI assigned
Sep 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95027027 CA Primary

Addresses

Primary practice location

2772 Johnson Dr Ste 114
Ventura, CA 93003-7261

Mailing address

2772 Johnson Dr Ste 114
Ventura, CA 93003-7261
Phone (805) 644-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603004364 CA Practitioner - Nurse Practitioner 0042781783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1723 S Cleveland St
Philadelphia, PA 19145-2106

PO Box
Phoenix, AZ 85072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95027027CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prax Medical Ca, PC Family CurrentSince May 20, 2026 Accepting new patients
Barry M. Cogen, D.O., Inc PastSince Sep 10, 2023 Accepting new patients

Locations

2108 N St
Sacramento, CA 95816
Phone (951) 719-7050

5214 Diamond Heights Blvd
San Francisco, CA 94131
Phone (510) 224-5934

Organizations & group practices 2

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1114703188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 JOHNSON DR STE 114",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037261",
            "telephone_number": "805-644-3311",
            "fax_number": "805-644-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2772 JOHNSON DR STE 114",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037261",
            "telephone_number": "805-644-3311",
            "fax_number": "805-644-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTOS",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.