Active NPI
Samantha Ryllo, PA
- Physician Assistant
- Livingston, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00876300
- Practice address
- 200 S Orange Ave Ste 102
Livingston, NJ 07039-5817 - Phone
- (973) 322-7020
- NPI assigned
- Jul 3, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 030278 | NY | |
| Physician Assistant | 363A00000X | 25MP00876300 | NJ | Primary |
Addresses
Primary practice location
200 S Orange Ave Ste 102
Livingston, NJ 07039-5817
Mailing address
379 Campus Dr FL 4
Somerset, NJ 08873-1161
Other practice location 1
1901 1st Ave
New York, NY 10029-7491
Phone (212) 423-6262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (732) 828-3000
Hospital & facility affiliations
- Cooperman Barnabas Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00876300 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group PC | Current | Accepting new patients | |
| Barnabas Health Medical Group PC | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Locations
475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000
200 S Orange Ave
Ste 102
Livingston, NJ 07039
Phone (973) 322-7020
112 Old Short HLS Rd
Livingston, NJ 07039
94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400
1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887
379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545
Interoperability endpoints
- sryllo3769450@nychhc.direct-ci.com
Organizations & group practices 5
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.
-
- Specialist
- Elizabeth, NJ
- NPI 1841557246
-
- General Practice Physician
- New York, NY
- NPI 1306138383
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Durable Medical Equipment & Medical Supplies
- Hackensack, NJ
- NPI 1316772668
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Livingston, NJ
- NPI 1396857488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1477230308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "379 CAMPUS DR FL 4",
"city": "SOMERSET",
"state": "NJ",
"postal_code": "088731161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S ORANGE AVE STE 102",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070395817",
"telephone_number": "973-322-7020"
}
],
"practiceLocations": [
{
"address_1": "1901 1st Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100297491",
"country_code": "US",
"telephone_number": "212-423-6262",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RYLLO",
"first_name": "SAMANTHA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "030278",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00876300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Livingston, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.