Individual provider Active NPI

Ryan Reno Dirienzo, PA-C

  • Physician Assistant
  • Ithaca, NY
National Provider Identifier
1205464344
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025842-01 Issued in NY
Practice address
16 Brentwood Dr
Ithaca, NY 14850-1863
Phone
(607) 272-7000
NPI assigned
Apr 1, 2020
Last updated
Nov 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025842-01 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

16 Brentwood Dr
Ithaca, NY 14850-1863

Mailing address

1 Eldorado Dr Apt D
Trumansburg, NY 14886-9333
Phone (860) 543-5528

Other practice location 1

3 Powder Mill Ln
North Granby, CT 06060-1216
Phone (860) 413-9048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210106002547 NY Practitioner - Physician Assistant 2769895911 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians
Capital Region Orthopaedic Associates, PCGroup PAC ID 3779496393, 67 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4296

1367 Washington Ave
Suite 200
Albany, NY 12206-1043
Phone (518) 489-2666

16 Brentwood Dr
Ithaca, NY 14850-1863
Phone (607) 277-2179

310 Taughannock Blvd
Suite 4
Ithaca, NY 14850-3251
Phone (607) 269-0100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025842-01NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler Hospital Inc CurrentSince Oct 1, 2022 Accepting new patients
Schuyler Hospital Inc Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
Capital Region Orthopaedic Associates, PC Single Specialty CurrentSince Aug 11, 2025 Accepting new patients

Locations

1367 Washington Ave
Ste 200
Albany, NY 12206
Phone (518) 489-2666

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

Interoperability endpoints

  • Direct secure messaging: rdirienzo27550@direct.xtensys.com
  • Direct secure messaging: ryan.dirienzo.1@28317.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1205464344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELDORADO DR APT D",
            "city": "TRUMANSBURG",
            "state": "NY",
            "postal_code": "148869333",
            "telephone_number": "860-543-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BRENTWOOD DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501863",
            "telephone_number": "607-272-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Powder Mill Ln",
            "address_purpose": "LOCATION",
            "city": "North Granby",
            "state": "CT",
            "postal_code": "060601216",
            "country_code": "US",
            "telephone_number": "860-413-9048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIRIENZO",
        "first_name": "RYAN",
        "middle_name": "RENO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025842-01",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.