Individual provider Active NPI

Ryan Eric Allen

  • Sports Medicine (Family Medicine) Physician
  • Las Vegas, NV
National Provider Identifier
1376172650
Registry record updated Jul 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
25536 Issued in NV
Practice address
9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Phone
(702) 240-8646
NPI assigned
Apr 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 25536 NV Primary

Addresses

Primary practice location

9010 W Cheyenne Ave
Las Vegas, NV 89129-8932

Mailing address

9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Phone (702) 240-8646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025003588 NV Practitioner - Family Practice 3577988955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nevada School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dana Forte D O LTDGroup PAC ID 1254239387, 14 clinicians

Practice addresses (Care Compare)

9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Phone (702) 240-8646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25536NVMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana Forte D O LTD CurrentSince Sep 3, 2024 Accepting new patients

Locations

2551 N Green Valley Pkwy
#425A
Henderson, NV 89014
Phone (702) 450-3385

9010 W Cheyenne Ave
Las Vegas, NV 89129
Phone (702) 240-8646

Organizations & group practices 1

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1376172650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9010 W CHEYENNE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298932",
            "telephone_number": "702-240-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 W CHEYENNE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298932",
            "telephone_number": "702-240-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "RYAN",
        "middle_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NV",
            "license": "25536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.