Individual provider Active NPI

Ryan Allen Quaderer, FNP-BC

  • Family Nurse Practitioner
  • Frankenmuth, MI
National Provider Identifier
1295449593
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704349937 Issued in MI
Practice address
600 N Main St
Frankenmuth, MI 48734-1152
Phone
(989) 652-1320
NPI assigned
Jan 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 4704349937 MI Primary

Addresses

Primary practice location

600 N Main St
Frankenmuth, MI 48734-1152

Mailing address

PO Box 41
Atlas, MI 48411-0041
Phone (810) 836-0241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240517003619 MI Practitioner - Nurse Practitioner 3375984511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rau Physical Therapy IncGroup PAC ID 2365721339, 98 clinicians
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

193 E Jefferson St
Frankenmuth, MI 48734-1935

600 N Main St
Frankenmuth, MI 48734-1152
Phone (989) 652-1320

Hospital & facility affiliations

  • Covenant at Home Home health agency, Saginaw, MI, CCN 237431
  • Covenant Medical Center Hospital, Saginaw, MI, CCN 230070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc CurrentSince May 13, 2024 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients

Locations

600 N Main St
Ste 220B
Frankenmuth, MI 48734
Phone (989) 583-6521

600 N Main St
Ste 210
Frankenmuth, MI 48734
Phone (989) 652-1440

600 N Main St
Frankenmuth, MI 48734
Phone (989) 652-1320

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

Interoperability endpoints

  • Direct secure messaging: rqauderer163826@direct.covenanthealthcare.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 2

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1295449593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41",
            "city": "ATLAS",
            "state": "MI",
            "postal_code": "484110041",
            "telephone_number": "810-836-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MAIN ST",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341152",
            "telephone_number": "989-652-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUADERER",
        "first_name": "RYAN",
        "middle_name": "ALLEN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-11",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704349937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankenmuth, MI

Sources for this page

Verify at the official NPI Registry.