Individual provider Active NPI

Ryan Stevens, RRA

  • Radiology Practitioner Assistant
  • Glens Falls, NY
National Provider Identifier
1306614854
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
License
R000209-01 Issued in NY
Practice address
100 Park St
Glens Falls, NY 12801-4413
Phone
(518) 926-1000
NPI assigned
Dec 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X R000209-01 NY Primary

Addresses

Primary practice location

100 Park St
Glens Falls, NY 12801-4413

Mailing address

3 Care LN Ste 100
Saratoga Springs, NY 12866-8636
Phone (518) 793-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R000209-01NYMDRadiology Practitioner Assistant

NPI Registry JSON

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1306614854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CARE LN STE 100",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128668636",
            "telephone_number": "518-793-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "RYAN",
        "credential": "RRA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": "NY",
            "license": "R000209-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.