Individual provider Active NPI

Ryan Anthony Kiehart, DC

  • Chiropractor
  • Oswego, NY
National Provider Identifier
1205424587
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013410 Issued in NY
Practice address
55 E Bridge St
Oswego, NY 13126-2120
Phone
(315) 342-6300
Fax
(315) 342-6302
NPI assigned
Jan 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 013410 NY Primary

Addresses

Primary practice location

55 E Bridge St
Oswego, NY 13126-2120

Mailing address

2757 Lower Lake Rd Apt B
Seneca Falls, NY 13148-9429
Phone (570) 267-8327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120001194 NY Practitioner - Chiropractic 8325452014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kiehart Chiropractic, P.C.Group PAC ID 3870936008, 2 clinicians

Practice addresses (Care Compare)

228 W Main St
Montour Falls, NY 14865-9517
Phone (607) 210-6069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony V. Licatese , DC, P.C. Chiropractor CurrentSince Jan 9, 2021 Accepting new patients
Kiehart Chiropractic, P.C. Chiropractor CurrentSince Nov 20, 2023 Accepting new patients

Locations

55 E Bridge St
Oswego, NY 13126
Phone (315) 342-6300

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": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1205424587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 LOWER LAKE RD APT B",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131489429",
            "telephone_number": "570-267-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E BRIDGE ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262120",
            "telephone_number": "315-342-6300",
            "fax_number": "315-342-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEHART",
        "first_name": "RYAN",
        "middle_name": "ANTHONY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.