NPIMap

Individual provider Active NPI

Audrey Ryan

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1154052777
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030966 Issued in NY
Practice address
6255 Sheridan Dr Ste 200
Williamsville, NY 14221-4825
Phone
(716) 564-1111
Fax
(716) 929-0194
NPI assigned
Jun 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 030966 NY Primary

Addresses

Primary practice location

6255 Sheridan Dr Ste 200
Williamsville, NY 14221-4825

Mailing address

6255 Sheridan Dr Ste 200
Williamsville, NY 14221-4825
Phone (716) 636-7979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240320001335 NY Practitioner - Physician Assistant 6204273733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highgate Medical Group PCGroup PAC ID 6901885565, 58 clinicians

Practice addresses (Care Compare)

6255 Sheridan Dr
Williamsville, NY 14221-4825
Phone (716) 636-7979

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030966NYMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: aryan@highgatemedical.medentdirect.com

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.

Hospital & facility affiliations 8

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1154052777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 SHERIDAN DR STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214825",
            "telephone_number": "716-636-7979",
            "fax_number": "716-929-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 SHERIDAN DR STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214825",
            "telephone_number": "716-564-1111",
            "fax_number": "716-929-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.