Individual provider Active NPI

Oleg A Ryabinin, M.D.

  • Surgery Physician
  • Camp Pendleton, CA
National Provider Identifier
1437499787
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A132400 Issued in CA
Practice address
200 Mercy Circle
Camp Pendleton, CA 92055
Phone
(760) 725-1356
NPI assigned
Feb 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 2022-01752 NC
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X A132400 CA Primary

Addresses

Primary practice location

200 Mercy Circle
Camp Pendleton, CA 92055

Mailing address

PO Box 555191
Camp Pendleton, CA 92055-5191
Phone (760) 725-1356

Other practice location 1

34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone (619) 532-8038

Other practice location 2

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 771-4229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250304000754 CA Practitioner - General Surgery 3173044419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A132400CAMDSurgery Physician
2022-01752NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 24, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 24, 2024 Accepting new patients
Southern California Permanente Medical Group Single Specialty Current Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

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 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": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1437499787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-1356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "619-532-8038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 Biltmore Ave",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288014601",
            "country_code": "US",
            "telephone_number": "828-771-4229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYABININ",
        "first_name": "OLEG",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-25",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": "2022-01752",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A132400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

Verify at the official NPI Registry.