NPIMap

Individual provider Active NPI

Bryan Lennon Ruygrok, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1265066047
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13485 Issued in TX
Practice address
6414 Fannin St Ste G150
Houston, TX 77030-1514
Phone
(713) 486-7560
Fax
(713) 486-7512
NPI assigned
Mar 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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 PA13485 TX Primary

Addresses

Primary practice location

6414 Fannin St Ste G150
Houston, TX 77030-1514

Mailing address

7550 Kirby Dr Apt 136
Houston, TX 77030-4364
Phone (410) 971-7885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200406000846 TX Practitioner - Physician Assistant 0749619179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

6410 Fannin St
Houston, TX 77030-3005

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

6414 Fannin St
Suite G125
Houston, TX 77030-1517

6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Apr 6, 2020 Accepting new patients
Ut Physicians Physician Assistant CurrentSince Apr 6, 2020 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

11476 Space Center Blvd
Ste 101
Houston, TX 77059

6414 Fannin St
Ste G150
Houston, TX 77030
Phone (713) 486-7560

Interoperability endpoints

  • Direct secure messaging: bruygrok11243@direct.uth.org

Organizations & group practices 2

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 8

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": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1265066047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 KIRBY DR APT 136",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304364",
            "telephone_number": "410-971-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6414 FANNIN ST STE G150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301514",
            "telephone_number": "713-486-7560",
            "fax_number": "713-486-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUYGROK",
        "first_name": "BRYAN",
        "middle_name": "LENNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.