Individual provider Active NPI

Ryan Dale Symanietz, PA-C

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1225412406
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2545 Chicago Ave
Suite 601
Minneapolis, MN 55404-4522
Phone
(612) 863-7770
Fax
(612) 863-7772
NPI assigned
Jul 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2545 Chicago Ave
Suite 601
Minneapolis, MN 55404-4522

Mailing address

2545 Chicago Ave
Suite 601
Minneapolis, MN 55404-4522
Phone (612) 863-7770

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsymanietz334902@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150901000386 MN Practitioner - Physician Assistant 2668788001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH Ave N
Saint Cloud, MN 56303-2735

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

1406 6TH Ave N
St Cloud, MN 56303-1901

1406 6TH Ave No
St Cloud, MN 56303-1901

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Alomere Health Hospital, Alexandria, MN, CCN 240030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2318MNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Mar 6, 2017 Accepting new patients
Centracare Clinic CurrentSince Mar 6, 2017 Accepting new patients

Locations

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

Interoperability endpoints

  • Direct secure messaging: rsymanietz334902@direct.centracare.com

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.

Hospital & facility affiliations 7

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": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1225412406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 CHICAGO AVE",
            "address_2": "SUITE 601",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044522",
            "telephone_number": "612-863-7770",
            "fax_number": "612-863-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 CHICAGO AVE",
            "address_2": "SUITE 601",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044522",
            "telephone_number": "612-863-7770",
            "fax_number": "612-863-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMANIETZ",
        "first_name": "RYAN",
        "middle_name": "DALE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsymanietz334902@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rsymanietz334902@direct.centracare.com",
            "address_1": "1200 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563032735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.