Individual provider Active NPI

Donna E Ryan

  • Medical Physician Assistant
  • Newark, NJ
National Provider Identifier
1396922993
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
268 Martin Luther King Jr Blvd
Newark, NJ 07102-2011
Phone
(973) 877-5414
NPI assigned
Jan 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

268 Martin Luther King Jr Blvd
Newark, NJ 07102-2011

Mailing address

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20090521000303 NJ Practitioner - Physician Assistant 1951470798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Partners LLCGroup PAC ID 2860665809, 74 clinicians

Practice addresses (Care Compare)

254 B Mountain Ave
Suite 304
Hackettstown, NJ 07840-2413
Phone (908) 852-6400

475 S St
Morristown, NJ 07960-6459
Phone (973) 971-5000

Hospital & facility affiliations

  • Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054
  • Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002072CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, LLC CurrentSince Mar 5, 2018 Accepting new patients
St Michael Infectious Disease Associates Past Accepting new patients
Primary Care Partners LLC Past Accepting new patients

Locations

475 South St
Morristown, NJ 07960
Phone (973) 660-3166

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

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 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": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1396922993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD",
            "address_2": "SUITE 101",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-281-0221",
            "fax_number": "908-281-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 MARTIN LUTHER KING JR BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022011",
            "telephone_number": "973-877-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "DONNA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.