Individual provider Active NPI

Martin Amani Ryan, DPM

  • Podiatrist
  • Media, PA
National Provider Identifier
1508558602
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC007381 Issued in PA
Practice address
280 N Providence Rd Ste 103
Media, PA 19063-3530
Phone
(610) 566-4563
NPI assigned
May 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC007381 PA Primary

Addresses

Primary practice location

280 N Providence Rd Ste 103
Media, PA 19063-3530

Mailing address

513 Spring Meadow LN
Webster, NY 14580-4043
Phone (585) 489-7722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401000774 PA Practitioner - Podiatry 9931692035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

280 N Providence Rd
Suite 103
Media, PA 19063-3530

4 E Athens Ave
Apt 102
Ardmore, PA 19003-2155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC007381PAMDPodiatrist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1508558602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 SPRING MEADOW LN",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145804043",
            "telephone_number": "585-489-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N PROVIDENCE RD STE 103",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633530",
            "telephone_number": "610-566-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARTIN",
        "middle_name": "AMANI",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC007381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.