NPIMap

Individual provider Active NPI

Ryan C Corn, DO

  • Neurology Physician
  • Du Bois, PA
National Provider Identifier
1386140705
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS024180 Issued in PA
Practice address
123 Hospital Ave
Ground Floor
Dubois, PA 15801
Phone
(814) 375-2070
Fax
(814) 375-3081
NPI assigned
Apr 4, 2018
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OS024180 PA Primary
Neurology Physician 2084N0400X 319359 NY

Addresses

Primary practice location

123 Hospital Ave
Ground Floor
Dubois, PA 15801

Mailing address

100 Nicolls Rd #271
HSC Level 12-020
Stony Brook, NY 11794
Phone (631) 444-2599

Other identifiers 2

IdentifierTypeStateIssuer
104446503-0001MedicaidPA
7G4018OtherPAMC PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204001903 PA Practitioner - Neurology 0143696880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

100 Hospital Ave
Du Bois, PA 15801-1440

145 Hospital Ave
Suite 211
Du Bois, PA 15801-1464
Phone (814) 375-2070

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
319359NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Neurology CurrentSince Dec 2, 2024 Accepting new patients
Dubois Regional Medical Center CurrentSince Dec 2, 2024 Accepting new patients

Locations

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

123 Hospital Ave
Dubois, PA 15801
Phone (814) 371-1510

145 Hospital Ave
Ste 211
Dubois, PA 15801
Phone (814) 375-2070

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 33

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1386140705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD #271",
            "address_2": "HSC LEVEL 12-020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2599",
            "fax_number": "631-759-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL AVE",
            "address_2": "GROUND FLOOR",
            "city": "DUBOIS",
            "state": "PA",
            "postal_code": "15801",
            "telephone_number": "814-375-2070",
            "fax_number": "814-375-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORN",
        "first_name": "RYAN",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OS024180",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "319359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104446503-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC PTAN",
            "identifier": "7G4018",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.