Individual provider Active NPI

Stacy R Ryan, PA

  • Medical Physician Assistant
  • Sellersville, PA
National Provider Identifier
1235178278
Registry record updated Dec 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051060 Issued in PA
Practice address
915 Lawn Ave
Suite 203
Sellersville, PA 18960-1551
Phone
(215) 257-3697
Fax
(215) 453-3410
NPI assigned
Jun 5, 2006
Last updated
Dec 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051060 PA Primary

Addresses

Primary practice location

915 Lawn Ave
Suite 203
Sellersville, PA 18960-1551

Mailing address

PO Box 1111
Harleysville, PA 19438-0907
Phone (215) 257-3697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040310000751 PA Practitioner - Physician Assistant 2860380763 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

1200 S Cedar Crest Blvd 3Rd FL Kasych
LVPG Burn Surgery
Allentown, PA 18103-6202
Phone (610) 402-8355

1200 S Cedar Crest Blvd FL
1 LVPG Nephrology
Allentown, PA 18103-6202
Phone (610) 402-8510

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

1701 Innovation Dr
York, PA 17408-8815
Phone (717) 843-8623

1703 Innovation Dr
York, PA 17408-8815

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

2501 N 3Rd St
Kline Health Center Foot and Ankle
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd St 2ND FL Kline HC
Reach Program
Harrisburg, PA 17110-1904
Phone (717) 782-2363

2501 N 3Rd St FL
2 Kline Health Center
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd Street 2ND Floor
Pinnaclehealth Psychological Associates
Harrisburg, PA 17110-1904
Phone (717) 782-2143

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

600 Commerce Blvd
Stroudsburg, PA 18360-6214
Phone (570) 424-7390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051060PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Dec 1, 2020 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 1, 2020 Accepting new patients
Pinnacle Health Medical Services CurrentSince Mar 1, 2025 Accepting new patients
St. Luke's Quakertown Hospital CurrentSince Mar 18, 2019 Accepting new patients
St. Luke's Quakertown Hospital CurrentSince Mar 18, 2019 Accepting new patients
St Luke's Physician Group Inc CurrentSince Apr 16, 2018 Accepting new patients
St Lukes Hospital CurrentSince Mar 18, 2019 Accepting new patients
St Luke's Hospital CurrentSince Mar 18, 2019 Accepting new patients
Family Care Centers Inc CurrentSince Nov 5, 2022 Accepting new patients
Pinnacle Health Medical Services CurrentSince Mar 1, 2025 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Apr 16, 2018 Accepting new patients

Locations

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

1104 North St
Jim Thorpe, PA 18229
Phone (570) 325-2400

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

700 Lawn Ave
Sellersville, PA 18960
Phone (215) 453-4000

915 Lawn Ave
Ste 201
Sellersville, PA 18960
Phone (215) 453-3360

915 Lawn Ave
Ste 203
Sellersville, PA 18960
Phone (215) 257-3697

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 6

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356307200000",
    "number": "1235178278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1111",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194380907",
            "telephone_number": "215-257-3697",
            "fax_number": "215-453-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 LAWN AVE",
            "address_2": "SUITE 203",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189601551",
            "telephone_number": "215-257-3697",
            "fax_number": "215-453-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "STACY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2012-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sellersville, PA

Sources for this page

Verify at the official NPI Registry.