Individual provider Active NPI

Ryan Dennis Walsh, MD

  • Neuro-ophthalmology Physician
  • Milwaukee, WI
National Provider Identifier
1396900437
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuro-ophthalmology PhysicianTaxonomy code 207WX0109X
License
57569 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-8710
Fax
(414) 805-1101
NPI assigned
Jul 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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 57569-20 WI
Neuro-ophthalmology Physician 207WX0109X 57569 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-8710

Other practice location 1

925 N 87th St
Milwaukee, WI 53226-4812
Phone (414) 955-2020

Other identifiers 1

IdentifierTypeStateIssuer
1396900437MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20120921000315 WI Practitioner - NeurologyPractitioner - Ophthalmology 6800044561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Ophthalmology
Education
Georgetown University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

1025 Regent St
Madison, WI 53715-1248
Phone (608) 282-2000

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Hospital & facility affiliations

  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57569WIMDNeuro-ophthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Oct 1, 2012 Accepting new patients
Dean Health Systems, Inc. CurrentSince May 5, 2023 Accepting new patients
Dean Health Systems, Inc CurrentSince May 5, 2023 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

1025 Regent St
Madison, WI 53715
Phone (608) 282-2000

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

925 N 87th St
Milwaukee, WI 53226
Phone (414) 955-2020

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: rwalshmd103580@direct.froedtert.com

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 1

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1396900437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8710",
            "fax_number": "414-805-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8710",
            "fax_number": "414-805-1101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 N 87th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264812",
            "country_code": "US",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "RYAN",
        "middle_name": "DENNIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "57569-20",
            "primary": false
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "WI",
            "license": "57569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396900437",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.