Individual provider Active NPI

Ryne Bowen, P.A.-C

  • Physician Assistant
  • Rochester, MN
National Provider Identifier
1386013308
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Sep 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

2500 Niles Rd
Ste 6
Saint Joseph, MI 49085-3268
Phone (269) 408-1660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170802001494 MI Practitioner - Physician Assistant 9537469499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Hospitals at Niles and St Joseph IncGroup PAC ID 7517929037, 134 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Corewell Health Lakeland Hospitals
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11931MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jun 1, 2018 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Jun 1, 2018 Accepting new patients

Locations

61 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 684-6777

2500 Niles Rd
Ste 1
Saint Joseph, MI 49085
Phone (269) 429-5000

2500 Niles Rd
Ste 6
Saint Joseph, MI 49085
Phone (269) 408-1660

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: rbowen1268633@epic00.corewelldirect.org
  • Direct secure messaging: rbowen29388@lakeland.midirect.net

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.

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1386013308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NILES RD",
            "address_2": "STE 6",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853268",
            "telephone_number": "269-408-1660",
            "fax_number": "269-408-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "RYNE",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.