Individual provider Active NPI

Jeffrey Ryck, CRNP

  • Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1346789351
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP017224 Issued in PA
Practice address
3101 Shippers Rd
Vestal, NY 13850-2080
Phone
(607) 250-2180
NPI assigned
Feb 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP017224 PA Primary

Addresses

Primary practice location

3101 Shippers Rd
Vestal, NY 13850-2080

Mailing address

215 York Ave
Towanda, PA 18848-1933
Phone (570) 881-0202

Other practice location 1

71 Hospital Dr
Towanda, PA 18848-9702
Phone (570) 265-6300

Other names 1

  • Mr. Jeffrey Michael Ryck Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeffrey.ryck@direct.lourdes.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221004000178 NY Practitioner - Nurse Practitioner 0446536858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of Lourdes Memorial Hospital IncGroup PAC ID 1254237779, 249 clinicians

Practice addresses (Care Compare)

3101 Shippers Rd
Suite 102
Vestal, NY 13850-2081
Phone (607) 251-2100

Hospital & facility affiliations

  • Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
346611NYMDLicensed Practical Nurse
SP017224PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jul 20, 2022 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Jul 20, 2022 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. Nurse Practitioner Current Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

276-280 Robinson St
Binghamton, NY 13904
Phone (607) 722-2769

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

501 Reynolds Rd
Johnson City, NY 13790
Phone (607) 797-6071

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

3101 Shippers Rd
Ste 102
Vestal, NY 13850
Phone (607) 251-2100

3101 Shippers Rd
Vestal, NY 13850
Phone (607) 250-2180

Interoperability endpoints

  • Direct secure messaging: jryck196759@direct-guthrie.org

Organizations & group practices 4

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 1

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": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1346789351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 YORK AVE",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188481933",
            "telephone_number": "570-881-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SHIPPERS RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502080",
            "telephone_number": "607-250-2180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Towanda",
            "state": "PA",
            "postal_code": "188489702",
            "country_code": "US",
            "telephone_number": "570-265-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYCK",
        "first_name": "JEFFREY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-23",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP017224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.ryck@direct.lourdes.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3101 Shippers Rd",
            "city": "Vestal",
            "state": "NY",
            "country_code": "US",
            "postal_code": "138502080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEFFREY",
            "last_name": "RYCK",
            "middle_name": "MICHAEL",
            "prefix": "MR.",
            "credential": "CRNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.