Individual provider Active NPI

Samuel Scott Ryan

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1255961553
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
10425 Huffmeister Rd Ste 320
Houston, TX 77065-3429
Phone
(281) 955-2650
Fax
(281) 955-5587
NPI assigned
Jan 25, 2020
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NU Primary

Addresses

Primary practice location

10425 Huffmeister Rd Ste 320
Houston, TX 77065-3429

Mailing address

11800 FM 1960 Rd W
Houston, TX 77065-3840
Phone (281) 955-2650

Other practice location 1

22485 Tomball Pkwy Ste 2100
Houston, TX 77070-1560
Phone (289) 195-5265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220407001989 TX Practitioner - Physician Assistant 0941696553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Urgent Care PLLCGroup PAC ID 4880071679, 115 clinicians

Practice addresses (Care Compare)

4057 Riley Fuzzel Rd
Spring, TX 77386-4632
Phone (281) 602-0450

9595 Six Pines Dr
Suite 1400
The Woodlands, TX 77380-1535
Phone (346) 478-1615

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Star Urgent Care Management Inc Past Accepting new patients

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, 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": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1255961553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653840",
            "telephone_number": "281-955-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 HUFFMEISTER RD STE 320",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653429",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22485 Tomball Pkwy Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770701560",
            "country_code": "US",
            "telephone_number": "289-195-5265",
            "fax_number": "281-955-5875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SAMUEL",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-25",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.