NPIMap

Individual provider Active NPI

Michael Hunter Ryan, MD

  • Phlebology Physician
  • Jefferson City, MO
National Provider Identifier
1497750855
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
License
0054 Issued in MO
Practice address
1620 Southridge Dr Ste B
Jefferson City, MO 65109-4005
Phone
(573) 632-2780
Fax
(573) 632-2784
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 118143 MO
Phlebology Physician 202K00000X 0054 MO Primary
Surgery Physician 208600000X 118143 MO

Addresses

Primary practice location

1620 Southridge Dr Ste B
Jefferson City, MO 65109-4005

Mailing address

1620 Southridge Dr Ste B
Jefferson City, MO 65109-4005
Phone (573) 632-2780

Other practice location 1

4004 Peach Ct Ste E
Columbia, MO 65203-3800
Phone (573) 632-2780

Other practice location 2

1070 S Bishop Ave
Rolla, MO 65401-4408
Phone (573) 632-2780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315000155 MO Practitioner - Cardiac SurgeryPractitioner - Vascular Surgery 5890684104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Vascular Surgery
Education
Columbia University College of Physicians and Surgeons, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1620 Southridge Dr
Suite B
Jefferson City, MO 65109-4005
Phone 57363227801000

Hospital & facility affiliations

  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068
  • Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
  • SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025
  • Maries Manor Nursing home, Vienna, MO, CCN 265249

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal831

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients
Curators of the University of Missouri Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.ryan@mvcl-mo.direct.office.nextgen.com

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 10

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1497750855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 SOUTHRIDGE DR STE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094005",
            "telephone_number": "573-632-2780",
            "fax_number": "573-632-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 SOUTHRIDGE DR STE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094005",
            "telephone_number": "573-632-2780",
            "fax_number": "573-632-2784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4004 Peach Ct Ste E",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652033800",
            "country_code": "US",
            "telephone_number": "573-632-2780",
            "fax_number": "573-632-2784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1070 S Bishop Ave",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654014408",
            "country_code": "US",
            "telephone_number": "573-632-2780",
            "fax_number": "573-632-2784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "118143",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "MO",
            "license": "0054",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "118143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.