Individual provider Active NPI

Afshin Ryan, PT, EN, DPT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1225151210
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39793 Issued in CA
Practice address
3838 Watt Ave Ste D404
Sacramento, CA 95821-2665
Phone
(916) 476-5260
Fax
(916) 468-4680
NPI assigned
Apr 6, 2007
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39793 CA Primary

Addresses

Primary practice location

3838 Watt Ave Ste D404
Sacramento, CA 95821-2665

Mailing address

PO Box 3765
Walnut Creek, CA 94598-0765
Phone (661) 233-1384

Other practice location 1

1545 Saint Marks Plz Ste 7
Stockton, CA 95207-6411
Phone (916) 476-5260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Manijeh Ryan MD Inc a Professional Corporation CurrentSince Oct 2, 2022 Accepting new patients

Locations

4180 Treat Blvd
Ste 100
Concord, CA 94518

3838 Watt Ave
Ste D404
Sacramento, CA 95821
Phone (916) 476-5260

1545 Saint Marks Plz
Ste 7
Stockton, CA 95207
Phone (916) 476-5260

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1225151210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3765",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945980765",
            "telephone_number": "661-233-1384",
            "fax_number": "510-344-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 WATT AVE STE D404",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212665",
            "telephone_number": "916-476-5260",
            "fax_number": "916-468-4680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 Saint Marks Plz Ste 7",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952076411",
            "country_code": "US",
            "telephone_number": "916-476-5260",
            "fax_number": "916-468-4680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "AFSHIN",
        "name_prefix": "Dr.",
        "credential": "PT, EN, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.