Individual provider Active NPI

Ryan Edward Stagg, M.D.

  • Psychiatry Physician
  • Lancaster, PA
National Provider Identifier
1205001849
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD468931 Issued in PA
Practice address
802 New Holland Ave Ste 100
Lancaster, PA 17602-2288
Phone
(717) 560-3782
Fax
(717) 560-3787
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD468931 PA Primary

Addresses

Primary practice location

802 New Holland Ave Ste 100
Lancaster, PA 17602-2288

Mailing address

802 New Holland Ave Ste 100
Lancaster, PA 17602-2288
Phone (717) 560-3782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200219001683 PA Practitioner - Psychiatry 7618192493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD468931PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Mar 23, 2020 Accepting new patients
Lancaster General Medical Group CurrentSince Mar 23, 2020 Accepting new patients
Lancaster General Medical Group Psychiatry Current Accepting new patients

Locations

802 New Holland Ave
Ste 100
Lancaster, PA 17602
Phone (717) 544-1427

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

676 E Main St
New Holland, PA 17557
Phone (717) 354-4671

Organizations & group practices 3

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1205001849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 NEW HOLLAND AVE STE 100",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022288",
            "telephone_number": "717-560-3782",
            "fax_number": "717-560-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 NEW HOLLAND AVE STE 100",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022288",
            "telephone_number": "717-560-3782",
            "fax_number": "717-560-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGG",
        "first_name": "RYAN",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD468931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.