Active NPI
Ryan Pane, CO
- Orthotist
- Trumbull, CT
National Provider Identifier
1538600069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- 000833577I
- Practice address
- 115 Technology Dr
Sutie Cp102
Trumbull, CT 06611-6337 - Phone
- (203) 261-1162
- NPI assigned
- Mar 16, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | 000833577I | CT | Primary |
Addresses
Primary practice location
115 Technology Dr
Sutie Cp102
Trumbull, CT 06611-6337
Mailing address
115 Technology Dr
Sutie Cp102
Trumbull, CT 06611-6337
Phone (203) 261-1162
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000833577I | CT | MD | Orthotist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1538600069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 TECHNOLOGY DR",
"address_2": "SUTIE CP102",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066116337",
"telephone_number": "203-261-1162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 TECHNOLOGY DR",
"address_2": "SUTIE CP102",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066116337",
"telephone_number": "203-261-1162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANE",
"first_name": "RYAN",
"credential": "CO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-16",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "CT",
"license": "000833577I",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trumbull, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.