Individual provider Active NPI

Iryna Rybak, PA

  • Medical Physician Assistant
  • West Sacramento, CA
National Provider Identifier
1134969702
Registry record updated Jul 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA64529 Issued in CA
Practice address
2101 Stone Blvd
West Sacramento, CA 95691-4044
Phone
(916) 945-1189
NPI assigned
May 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA64529 CA Primary

Addresses

Primary practice location

2101 Stone Blvd
West Sacramento, CA 95691-4044

Mailing address

2101 Stone Blvd
West Sacramento, CA 95691-4044

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
I20241114000723 CA Practitioner - Physician Assistant 7315471240 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64529CAMDDentist
PA64529CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Garcia, Lee & Concepcion Medical Group CurrentSince Sep 8, 2024 Accepting new patients

Locations

2101 Stone Blvd
Ste 190
West Sacramento, CA 95691
Phone (916) 371-4939

Interoperability endpoints

  • Direct secure messaging: irybak239015@hpmg.direct-ci.net
  • Direct secure messaging: iryna.rybak.1@18067.direct.athenahealth.com

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": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1134969702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 STONE BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956914044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 STONE BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956914044",
            "telephone_number": "916-945-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYBAK",
        "first_name": "IRYNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA64529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

Verify at the official NPI Registry.