Individual provider Active NPI

Ryan Martini, PA-C

  • Physician Assistant
  • Portage, IN
National Provider Identifier
1306466479
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3691 Willowcreek Rd
Portage, IN 46368-5080
Phone
(219) 921-1444
Fax
(219) 921-5303
NPI assigned
Apr 19, 2020
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 Primary

Addresses

Primary practice location

3691 Willowcreek Rd
Portage, IN 46368-5080

Mailing address

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Other practice location 1

2501 Cumberland Dr
Valparaiso, IN 46383-2503
Phone (219) 921-1444

Other practice location 2

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Other practice location 3

833 W Lincoln Hwy Ste 110
Schererville, IN 46375-1674
Phone (219) 921-1444

Other practice location 4

500 E 109th Ave
Crown Point, IN 46307-7294
Phone (219) 921-1444

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address r.martini@lbji.exscribedirect.com Direct
Direct Messaging Address r.martini@lbji.exscribedirect.com Direct
Direct Messaging Address r.martini@lbji.exscribedirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210701001681 IN Practitioner - Physician Assistant 5395146054 Reassigns benefits to 1 organization

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
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589

500 E 109TH Ave
Crown Point, IN 46307-7294
Phone (219) 921-1444

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.8 of 100Reported as group
Quality
81.02
Improvement activities
40
Cost
74.12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Bone & Joint Institute, PC Current Accepting new patients

Locations

601 Gateway Blvd N
Chesterton, IN 46304
Phone (219) 921-1401

500 E 109th Ave
Crown Point, IN 46307

3691 Willowcreek Rd
Portage, IN 46368
Phone (219) 759-4380

3691 Willowcreek Rd
Ste 100
Portage, IN 46368
Phone (219) 759-4380

833 W Lincoln Hwy
Ste 110
Schererville, IN 46375

2501 Cumberland Dr
Valparaiso, IN 46383
Phone (219) 462-4481

Interoperability endpoints

  • Direct secure messaging: rmartini603206@direct.franciscanalliance.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1587254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1306466479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GATEWAY BLVD N",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049658",
            "telephone_number": "219-921-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3691 WILLOWCREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685080",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Cumberland Dr",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463832503",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Gateway Blvd N",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "463049658",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "833 W Lincoln Hwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Schererville",
            "state": "IN",
            "postal_code": "463751674",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 E 109th Ave",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463077294",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "r.martini@lbji.exscribedirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2501 Cumberland Dr",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463832503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "r.martini@lbji.exscribedirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3691 Willowcreek Rd",
            "city": "Portage",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463685080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "r.martini@lbji.exscribedirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 Gateway Blvd N",
            "city": "Chesterton",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463049658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

Verify at the official NPI Registry.