Individual provider Active NPI

Janesa Ryan, NP-C

  • Nurse Practitioner
  • Spearfish, SD
National Provider Identifier
1376195222
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP001586 Issued in SD
Practice address
1445 North Ave
Spearfish, SD 57783-1552
Phone
(605) 644-4170
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP001586 SD
Nurse Practitioner 363L00000X CP001586 SD Primary

Addresses

Primary practice location

1445 North Ave
Spearfish, SD 57783-1552

Mailing address

893 Oak Creek Rd
Aladdin, WY 82710-9724
Phone (605) 641-7595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20190917001858 SD Practitioner - Nurse Practitioner 7618206673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, 163 clinicians

Practice addresses (Care Compare)

1220 Montgomery St
Custer, SD 57730-1705
Phone (605) 673-4150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP001586SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. Current Accepting new patients
Monument Health Network, Inc. CurrentSince Jul 19, 2019 Accepting new patients
Monument Health Network, Inc. CurrentSince Jul 19, 2019 Accepting new patients
Queen City Regional Medical Clinic Past Accepting new patients

Locations

1220 Montgomery St
Custer, SD 57730
Phone (605) 673-4150

61 Charles St
Deadwood, SD 57732
Phone (605) 717-6000

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536

2140 Junction Ave
Sturgis, SD 57785
Phone (605) 720-2400

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 11

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1376195222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 OAK CREEK RD",
            "city": "ALADDIN",
            "state": "WY",
            "postal_code": "827109724",
            "telephone_number": "605-641-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 NORTH AVE",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831552",
            "telephone_number": "605-644-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JANESA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001586",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP001586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

Verify at the official NPI Registry.