Individual provider Active NPI

Christopher W Ryan, MD

  • Family Medicine Physician
  • Johnson City, NY
National Provider Identifier
1205824141
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
177903 Issued in NY
Practice address
40 Arch St
Johnson City, NY 13790-2102
Phone
(607) 763-6075
Fax
(607) 763-5234
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 177903 NY Primary

Addresses

Primary practice location

40 Arch St
Johnson City, NY 13790-2102

Mailing address

58 Lusk St
Johnson City, NY 13790-2541
Phone (607) 763-6293

Other identifiers 1

IdentifierTypeStateIssuer
01466348MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091118000728 NY Practitioner - Family Practice 5496893026 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Jul 1, 1994 Accepting new patients
United Medical Associates PC Past Accepting new patients

Locations

33 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2340

40 Arch St
Johnson City, NY 13790
Phone (607) 763-6075

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1205824141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 LUSK ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902541",
            "telephone_number": "607-763-6293",
            "fax_number": "607-763-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ARCH ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902102",
            "telephone_number": "607-763-6075",
            "fax_number": "607-763-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "177903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01466348",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.