Individual provider Active NPI

Ann Ita Ryan, MD

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1124034467
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G87694 Issued in CA
Practice address
1304 15TH St
Suite 400
Santa Monica, CA 90404-1809
Phone
(310) 395-9442
Fax
(310) 434-9101
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G87694 CA Primary

Addresses

Primary practice location

1304 15TH St
Suite 400
Santa Monica, CA 90404-1809

Mailing address

1304 15TH St
Suite 400
Santa Monica, CA 90404-1809
Phone (310) 395-9442

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061204000681 CA Practitioner - Family Practice 5597764472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

1304 15TH St
Suite 400
Santa Monica, CA 90404-1813
Phone (310) 395-9442

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

Hospital & facility affiliations

  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87694CAMDClinical Social Worker
G87694CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Family Medicine CurrentSince Jul 1, 2007 Accepting new patients
Woodland Hills Medical Clinic II Inc. Family Medicine Current Accepting new patients
The Regents of the University of California CurrentSince Jul 1, 2007 Accepting new patients
West Hills Hospital Past Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients
The Regents of the University of California Past Accepting new patients
Advocate Sherman Hospital Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

1304 15th St
Ste 400
Santa Monica, CA 90404
Phone (310) 395-9442

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

5995 Topanga Canyon Blvd
Woodland Hls, CA 91367
Phone (818) 888-7009

19825 Ventura Blvd
Woodland Hls, CA 91364
Phone (818) 274-4609

Interoperability endpoints

  • Direct secure messaging: aryan48740@direct.uclahealth.org

Organizations & group practices 7

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 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1124034467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 15TH ST",
            "address_2": "SUITE 400",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041809",
            "telephone_number": "310-395-9442",
            "fax_number": "310-434-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 15TH ST",
            "address_2": "SUITE 400",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041809",
            "telephone_number": "310-395-9442",
            "fax_number": "310-434-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ANN",
        "middle_name": "ITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G87694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.