Individual provider Active NPI

Angela M Ryerson, PA

  • Dermatology Physician
  • Nutley, NJ
National Provider Identifier
1508636432
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
24MP00813800 Issued in NJ
Practice address
88 Park Ave Ste 2a
Nutley, NJ 07110-3500
Phone
(973) 571-2121
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 24MP00813800 NJ Primary

Addresses

Primary practice location

88 Park Ave Ste 2a
Nutley, NJ 07110-3500

Mailing address

25 Cypress Dr
Denville, NJ 07834-1709
Phone (973) 590-4935

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109001488 NJ Practitioner - Physician Assistant 4486005923 Reassigns benefits to 1 organization

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
Schweiger Dermatology PCGroup PAC ID 0143442806, 180 clinicians

Practice addresses (Care Compare)

2 Hudson PL
Hoboken, NJ 07030-5594
Phone (212) 283-3000

315 E Northfield Rd
Suite 2a
Livingston, NJ 07039-4800
Phone (973) 878-0850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Dermatology Group Single Specialty CurrentSince Jan 7, 2024 Accepting new patients

Locations

88 Park Ave
Ste 2A
Nutley, NJ 07110
Phone (973) 434-1402

Organizations & group practices 2

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": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1508636432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CYPRESS DR",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078341709",
            "telephone_number": "973-590-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 PARK AVE STE 2A",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103500",
            "telephone_number": "973-571-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYERSON",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "24MP00813800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

Verify at the official NPI Registry.