NPIMap

Individual provider Active NPI

Ryan Glenn Miyamoto, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fairfax, VA
National Provider Identifier
1497923288
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
0101245582 Issued in VA
Practice address
3620 Joseph Siewick Dr Ste 201
Fairfax, VA 22033-1758
Phone
(703) 391-0111
Fax
(703) 391-2945
NPI assigned
Feb 14, 2008
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 0101245582 VA Primary

Addresses

Primary practice location

3620 Joseph Siewick Dr Ste 201
Fairfax, VA 22033-1758

Mailing address

1860 Town Center Dr Ste 300
Reston, VA 20190-5900
Phone (703) 435-6604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091208000285 DC Practitioner - Orthopedic Surgery 6204996390 Reassigns benefits to 1 organization
I20160413001657 VA Practitioner - Orthopedic Surgery 6204996390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Maryland School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

1860 Town Ctr Dr
Suite 300
Reston, VA 20190-5900
Phone (703) 435-6604

2585 Miracle Mile
Bullhead City, AZ 86442-7522

44095 Pipeline PLZ
Suite 370
Ashburn, VA 20147-7518
Phone (703) 435-6604

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Town Center Orthopaedic Associates PC CurrentSince Jan 3, 2022 Accepting new patients
Town Center Orthopaedic Associates, P.C. Sports Medicine CurrentSince Jan 3, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Steadman Clinic Professional LLC Sports Medicine Past Accepting new patients

Locations

44095 Pipeline Plz
Ste 370
Ashburn, VA 20147
Phone (571) 623-3500

6201 Centreville Rd
Ste 600
Centreville, VA 20121
Phone (571) 261-6177

11166 Fairfax Blvd
Ste 400
Fairfax, VA 22030
Phone (703) 691-3015

1860 Town Center Dr
Ste 300
Reston, VA 20190
Phone (703) 483-4684

Interoperability endpoints

  • Direct secure messaging: rmiyamoto@tcoa.emadirect.md

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, 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": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1497923288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR STE 300",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905900",
            "telephone_number": "703-435-6604",
            "fax_number": "703-662-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 JOSEPH SIEWICK DR STE 201",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331758",
            "telephone_number": "703-391-0111",
            "fax_number": "703-391-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYAMOTO",
        "first_name": "RYAN",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101245582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.