Kelly Ryan

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00333400 Issued in NJ

Practice address

65 James St
Edison, NJ 08820-3947

Phone

(732) 321-7000

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
• Direct secure messaging: kar9098@direct.nyp.org

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.

• Kings Physician Services, PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1083045090

  NY

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  NJ

  Medicare reassignment
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Hackensack Meridian Health Medical Group - Complex Care PC

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1194806539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00333400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Ann Rusin, PT
• Alexander Peter Russoniello, MD
• George Junior Rusuloj, PHARM. D
• Jill Ryan-Bisogne, RPH
• Christina Marie Ryan, M.D.
• Todd C Ryan, D.O.
• Mahnoor Sabir
• Lauren Julia Sacco, PT, DPT
• Rahul Sachdev, M.D.
• Virginia Sadowski

• Surgical Physician Assistant in Edison, NJ
• Providers in Edison, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.