Individual provider Active NPI

Ryan Bruce Myers, DPT

  • Physical Therapist
  • Attleboro, MA
National Provider Identifier
1366726846
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19626 Issued in MA
Practice address
75 S Main St
Attleboro, MA 02703-2924
Phone
(508) 603-9525
Fax
(508) 452-0095
NPI assigned
Oct 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19626 MA Primary

Addresses

Primary practice location

75 S Main St
Attleboro, MA 02703-2924

Mailing address

75 S Main St
Attleboro, MA 02703-2924
Phone (508) 603-9525

Other identifiers 3

IdentifierTypeStateIssuer
1222471OtherMAASH/CIGNA
110094254AMedicaidMA
9560858OtherMAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120106000009 MA Practitioner - Physical Therapist in Private Practice 7214103670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Physical Therapy LLCGroup PAC ID 1951295187, 73 clinicians

Practice addresses (Care Compare)

75 S Main St
Unit 102
Attleboro, MA 02703-2924
Phone (508) 306-9525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy, LLC Physical Therapist CurrentSince Jan 3, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1366726846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 S MAIN ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032924",
            "telephone_number": "508-603-9525",
            "fax_number": "508-452-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S MAIN ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032924",
            "telephone_number": "508-603-9525",
            "fax_number": "508-452-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "RYAN",
        "middle_name": "BRUCE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-03",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASH/CIGNA",
            "identifier": "1222471",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110094254A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9560858",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Attleboro, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.