Ryan Michael Ebisu, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD61396821 Issued in WA

Practice address

751 NE Blakely Dr
Issaquah, WA 98029-6201

Phone

(253) 460-7714

NPI assigned

Apr 13, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ryan Ebisu Professional name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Hawaii John a. Burns School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Eastside Emergency Physicians PLLCGroup PAC ID 5193725372, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Issaquah Hospital, Issaquah, WA, CCN 500152
• Swedish Medical Center Hospital, Seattle, WA, CCN 500027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eastside Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Issaquah, WA
  • NPI 1689683229
  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment Care Compare group NPD
• Eastside Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Everett, WA
  • NPI 1922303478
  NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation
• Swedish Health Services

  dba Swedish/Issaquah

  • General Acute Care Hospital
  • Issaquah, WA
  • NPI 1851686059
  Care Compare affiliation

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1306465174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 HIGHLANDS DR NE # 110-35",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296245",
            "telephone_number": "425-346-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "253-460-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBISU",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61396821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "EBISU",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Eastside Social Skills Therapy
• Eastside Social Skills Therapy LLC
• Eastside Therapy Associates LLC (Eastside Occupational Therapy)
• Eastside Therapy Services
• Jessica Lynn Ebberson
• Katie Edwards
• David Ege, MD
• Nadine Egger, DDS, MSD
• Erika Eichelberger, LMHCA
• Nathan M Eilers, RPH

• Emergency Medicine Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.