Individual provider Active NPI

Ryan Shane Tighe

  • Anesthesiologist Assistant
  • Fort Wayne, IN
National Provider Identifier
1366952095
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
75000153A Issued in IN
Practice address
11141 Parkview Plaza Dr Ste 200
Fort Wayne, IN 46845-1714
Phone
(260) 425-6030
Fax
(260) 425-6028
NPI assigned
Oct 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000312 OH
Anesthesiologist Assistant 367H00000X 75000153A IN Primary

Addresses

Primary practice location

11141 Parkview Plaza Dr Ste 200
Fort Wayne, IN 46845-1714

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171117002403 OH Practitioner - Anesthesiology Assistant 1850657222 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
A4 of Ohio LLCGroup PAC ID 3971837188, 33 clinicians

Practice addresses (Care Compare)

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3578

4235 Secor Rd
Toldeo, OH 43623-4231
Phone (419) 473-3561

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

Merit-based Incentive Payment System (MIPS)

Final score
34.63 of 100Reported as group
Quality
23.09
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.34 of 100Reported as group
Quality
69.17
Promoting interoperability
99
Improvement activities
40
Cost
75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
75000153AINMDAnesthesiologist Assistant
67.000312OHMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Toledo Physicians LLC CurrentSince Oct 17, 2017 Accepting new patients
Ohio Anesthesia Group, Inc CurrentSince Oct 28, 2020 Accepting new patients
A4 of Ohio, LLC Anesthesiologist Assistant CurrentSince Nov 15, 2021 Accepting new patients
Medical University of Ohio at Toledo Current Accepting new patients
Medical University of Ohio Past Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

L4189
Columbus, OH 43260

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

5959 Monclova Rd
Maumee, OH 43537
Phone (419) 251-3740

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

3355 Glendale Ave
Fl 3
Toledo, OH 43614
Phone (419) 383-7100

3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

4235 Secor Rd
Bldg 2
Toledo, OH 43623
Phone (419) 473-3561

3000 Arlington Ave
#1137
Toledo, OH 43614
Phone (419) 383-3514

Interoperability endpoints

  • Direct secure messaging: rtighe25226@direct.utoledo.edu

Organizations & group practices 5

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 2

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": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1366952095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451714",
            "telephone_number": "260-425-6030",
            "fax_number": "260-425-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIGHE",
        "first_name": "RYAN",
        "middle_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-09",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000312",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000153A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.