Active NPI
Ryan McKim, PSY.D.
- Clinical Neuropsychologist
- San Francisco, CA
National Provider Identifier
1407180656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 22874
- Practice address
- 530 Divisadero St
Suite 203
San Francisco, CA 94117-2213 - Phone
- (415) 531-9202
- NPI assigned
- Sep 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 22874 | CA | Primary |
| Psychologist | 103T00000X | 22874 | CA |
Addresses
Primary practice location
530 Divisadero St
Suite 203
San Francisco, CA 94117-2213
Mailing address
530 Divisadero St
Suite 203
San Francisco, CA 94117-2213
Phone (415) 531-9202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22874 | CA | MD | Ambulatory Care Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark David Levine, MD Burlingame PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- San Mateo, CA
- NPI 1770709263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253491200000",
"number": "1407180656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 DIVISADERO ST",
"address_2": "SUITE 203",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941172213",
"telephone_number": "415-531-9202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 DIVISADERO ST",
"address_2": "SUITE 203",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941172213",
"telephone_number": "415-531-9202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKIM",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-21",
"last_updated": "2009-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "22874",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "22874",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.