Ryan Matthew Fenoli

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

505 S 336TH St Ste 500
Federal Way, WA 98003-8300

Phone

(657) 400-5180

NPI assigned

Jul 30, 2021

Last updated

Jul 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: rfenoli@landmarkhealth-direct.org

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1225701600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7718 NE 151ST LN",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980285600",
            "telephone_number": "425-638-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST STE 500",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038300",
            "telephone_number": "657-400-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENOLI",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Federal Way Womens Health Care
• Lavonne E. Felton, P.A.
• Terry Jo Felts X, DPM
• Sarah Feng
• Jamie Isaacson Fenimore
• Bethany Ferguson
• Amanda Michelle Ferland, MS DPT
• Robyn Fernando
• Michael Ferrara
• Ronald Damon Ferrians, LMT

• Physician Assistant in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.