NPIMap

Individual provider Active NPI

Sharon Ryan, M.D.

  • Family Medicine Physician
  • Old Bridge, NJ
National Provider Identifier
1407824691
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA53674 Issued in NJ
Practice address
2107 Highway 516
Old Bridge, NJ 08857-1746
Phone
(732) 952-0626
Fax
(732) 463-6071
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 25MA05367400 NJ
Family Medicine Physician 207Q00000X MA53674 NJ Primary

Addresses

Primary practice location

2107 Highway 516
Old Bridge, NJ 08857-1746

Mailing address

2107 Highway 516
Old Bridge, NJ 08857-1746
Phone (732) 952-0626

Other identifiers 1

IdentifierTypeStateIssuer
4561601MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040421001042 NJ Practitioner - Family Practice 3274529797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Practice addresses (Care Compare)

2107 Hwy 516
Suite a
Old Bridge, NJ 08857-1746
Phone (732) 952-0626

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA53674NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services Family Medicine CurrentSince May 29, 2021 Accepting new patients

Locations

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300

2107 Highway 516
Ste A
Old Bridge, NJ 08857
Phone (732) 952-0626

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Interoperability endpoints

  • Direct secure messaging: sryan15071@epicdirect.rwjbh.org

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

Hospital & facility affiliations 6

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1407824691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 HIGHWAY 516",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571746",
            "telephone_number": "732-952-0626",
            "fax_number": "732-463-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 HIGHWAY 516",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571746",
            "telephone_number": "732-952-0626",
            "fax_number": "732-463-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA05367400",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA53674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4561601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.