Active NPI
Ryan Davisson
- Physician Assistant
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.006015
- Practice address
- 1500 S Fairfield Ave
Chicago, IL 60608-1782 - Phone
- (773) 257-5097
- NPI assigned
- Oct 6, 2016
- Last updated
- Oct 6, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.006015 | IL | Primary |
Addresses
Primary practice location
1500 S Fairfield Ave
Chicago, IL 60608-1782
Mailing address
1500 S Fairfield Ave
Chicago, IL 60608-1782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.41 of 100
- Quality
- 86.81
- Improvement activities
- 40
- Cost
- 77.34
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.006015 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cepamerica Illinois LLP | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Cepamerica Illinois LLP | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701
26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900
1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- Elgin, IL
- NPI 1912283110
-
dba Sinai Medical Group
- Rehabilitation Hospital
- Chicago, IL
- NPI 1376715896
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1265954465
-
- Emergency Medicine Physician
- Springfield, IL
- NPI 1871360297
-
dba SMG at 47th Street
- Obstetrics & Gynecology Physician
- Chicago, IL
- NPI 1386060986
-
dba Sinai Medical Group
- General Acute Care Hospital
- Chicago, IL
- NPI 1982657854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1215487830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S FAIRFIELD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 S FAIRFIELD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606081782",
"telephone_number": "773-257-5097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISSON",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-06",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.006015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.