Individual provider Active NPI

Amanda G Ryder, MD

  • Family Medicine Physician
  • Yakima, WA
National Provider Identifier
1205857331
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00036727 Issued in WA
Practice address
504 N 40TH Ave
Yakima, WA 98908-4311
Phone
(509) 966-9480
Fax
(509) 966-3283
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MD00036727 WA Primary

Addresses

Primary practice location

504 N 40TH Ave
Yakima, WA 98908-4311

Mailing address

PO Box 2947
Yakima, WA 98907-2947
Phone (509) 248-7849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100105000737 WA Practitioner - Family Practice 7517008071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

406 S 30TH Ave
Suite 101
Yakima, WA 98902-3713
Phone (509) 248-7715

Hospital & facility affiliations

  • Mountainview Home Health Home health agency, Yakima, WA, CCN 507115
  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
  • Kittitas Valley Community Hospital Hospital, Ellensburg, WA, CCN 501333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036727WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Jan 19, 2020 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jan 19, 2020 Accepting new patients

Locations

4003 Creekside Loop
Yakima, WA 98908
Phone (509) 248-3263

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

504 N 40th Ave
Yakima, WA 98908

406 S 30th Ave
Ste 101
Yakima, WA 98902
Phone (509) 248-7715

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.

Hospital & facility affiliations 3

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205857331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2947",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072947",
            "telephone_number": "509-248-7849",
            "fax_number": "509-249-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N 40TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989084311",
            "telephone_number": "509-966-9480",
            "fax_number": "509-966-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "AMANDA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00036727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.