Jacqueline Ryan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

301 Becker Ave SW
Willmar, MN 56201-3302

Phone

(320) 231-4570

NPI assigned

Sep 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carris Health LLCGroup PAC ID 7012274228, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare- Rice Memorial Hospital Hospital, Willmar, MN, CCN 240088
• Meeker Memorial Hospital Hospital, Litchfield, MN, CCN 241366
• Chippewa County Hospital Hospital, Montevideo, MN, CCN 241325
• Centracare - Benson Hospital, Benson, MN, CCN 241365

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jryan628088@direct.centracare.com

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.

• Carris Health LLC

  • Emergency Medicine Physician
  • Willmar, MN
  • NPI 1134632680
  Medicare reassignment Care Compare group NPD
• Centracare Clinic Southwest LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1174106264
  Medicare reassignment
• Carris Health LLC

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1427684612
  NPD
• Centracare Clinic Southwest LLC

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1912664889
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carris Health LLC

  • Infusion Therapy Clinic/Center
  • Willmar, MN
  • NPI 1124657150

  Hospital

  Care Compare affiliation
• Carris Health LLC

  • General Acute Care Hospital
  • Willmar, MN
  • NPI 1407367030
  Care Compare affiliation
• CCM Health

  • Urgent Care Clinic/Center
  • Montevideo, MN
  • NPI 1275057978

  Hospital

  Care Compare affiliation
• CCM Health

  • Critical Access Hospital
  • Montevideo, MN
  • NPI 1720086028
  Care Compare affiliation
• Centracare Health - Benson LLC

  • Critical Access Hospital
  • Benson, MN
  • NPI 1326757154
  Care Compare affiliation
• County of Meeker

  • Rural Health Clinic/Center
  • Litchfield, MN
  • NPI 1083221816

  Hospital

  Care Compare affiliation
• County of Meeker

  • Critical Access Hospital
  • Litchfield, MN
  • NPI 1598860215
  Care Compare affiliation
• County of Meeker

  • Rural Health Clinic/Center
  • Dassel, MN
  • NPI 1952555146

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1467068064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BECKER AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BECKER AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013302",
            "telephone_number": "320-231-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan E Rolighed
• Nancy J Rost, MD
• Laura Lee Runia
• Kimberly Diane Rupp-Montpetit, CRNA
• Heather Marie Russell
• Joseph M Ryan, MD
• Mari Ryberg
• Steven P. Saccoman, DPM
• Salaam Transportation Inc
• Hassan Mohamed Saleban

• Physician Assistant in Willmar, MN
• Providers in Willmar, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.