Individual provider Active NPI

Ryan Joseph Gnesda, D.O.

  • Diagnostic Radiology Physician
  • Aberdeen, SD
National Provider Identifier
1437425733
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11113 Issued in SD
Practice address
305 S State St
Aberdeen, SD 57401-4527
Phone
(605) 622-5540
Fax
(605) 622-2804
NPI assigned
Mar 30, 2012
Last updated
Sep 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 11113 SD Primary

Addresses

Primary practice location

305 S State St
Aberdeen, SD 57401-4527

Mailing address

PO Box 1460
Aberdeen, SD 57402-1460
Phone (605) 622-2876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20181115000838 SD Practitioner - Interventional Radiology 8022362789 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11113SDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Luke's Current Accepting new patients
Avera St. Lukes CurrentSince Sep 10, 2018 Accepting new patients
Avera St Lukes CurrentSince Sep 10, 2018 Accepting new patients

Locations

305 S State St
Aberdeen, SD 57401
Phone (605) 229-3000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1437425733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574021460",
            "telephone_number": "605-622-2876",
            "fax_number": "605-622-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S STATE ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014527",
            "telephone_number": "605-622-5540",
            "fax_number": "605-622-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNESDA",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-30",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SD",
            "license": "11113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.