Individual provider Active NPI

Ryan B Israelsen, M.D.

  • Allergy & Immunology Physician
  • Medford, OR
National Provider Identifier
1487910766
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD187596 Issued in OR
Practice address
3121 Signature CT
Medford, OR 97504-7738
Phone
(541) 858-1003
Fax
(541) 255-2997
NPI assigned
Apr 11, 2012
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD187596 OR Primary
Internal Medicine Physician 207R00000X MD187596 OR
Pediatrics Physician 208000000X MD187596 OR
Pediatric Allergy/Immunology Physician 2080P0201X MD187596 OR

Addresses

Primary practice location

3121 Signature CT
Medford, OR 97504-7738

Mailing address

3121 Signature CT
Medford, OR 97504-7738
Phone (541) 858-1018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20180515001905 OR Practitioner - Allergy/ImmunologyPractitioner - Internal MedicinePractitioner - Pediatric Medicine 0648499525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine, Pediatric Medicine
Education
University of Utah School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3860 Crater Lake Ave
Suite a
Medford, OR 97504-9741
Phone (541) 858-1003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD187596ORMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy & Asthma Center of Southern Oregon PC CurrentSince Jul 6, 2018 Accepting new patients
Allergy & Asthma Center of Southern Oregon PC Allergy & Immunology CurrentSince Jul 6, 2018 Accepting new patients
Allergy & Asthma Center of Southern Oregon PC PastSince Jul 12, 2020 Accepting new patients

Locations

2628 Clover St
Klamath Falls, OR 97601
Phone (541) 858-1003

3860 Crater Lake Ave
Ste A
Medford, OR 97504
Phone (541) 858-1003

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.

Hospital & facility affiliations 4

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1487910766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 SIGNATURE CT",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047738",
            "telephone_number": "541-858-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 SIGNATURE CT",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047738",
            "telephone_number": "541-858-1003",
            "fax_number": "541-255-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAELSEN",
        "first_name": "RYAN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "OR",
            "license": "MD187596",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD187596",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD187596",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "OR",
            "license": "MD187596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.