Individual provider Active NPI

Jordan Ryba, PHYSICIAN ASSISTANT

  • Physician Assistant
  • East Point, GA
National Provider Identifier
1558844902
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8951 Issued in GA
Practice address
3515 Camp Creek Pkwy Ste 110
East Point, GA 30344-8411
Phone
(043) 447-3374
Fax
(404) 344-8338
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8951 GA Primary

Addresses

Primary practice location

3515 Camp Creek Pkwy Ste 110
East Point, GA 30344-8411

Mailing address

2454 Briarmoor Rd NE
Atlanta, GA 30345-2112
Phone (770) 630-5341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190506001892 GA Practitioner - Physician Assistant 4284976697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1034 Old Peachtree Rd NW
Lawrenceville, GA 30043-3308
Phone (678) 335-5400

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2701 Holcomb Bridge Rd
Alpharetta, GA 30022-6812
Phone (770) 998-7611

2925 Buford Dr
Apt 1110
Buford, GA 30519-5222
Phone (678) 535-0400

5438 Peachtree Blvd
Chamblee, GA 30341-2232
Phone (470) 816-0988

6660 Roswell Nerd
Sandy Springs, GA 30328-3167
Phone (404) 996-0195

789 Church St NE
Suite 200
Marietta, GA 30060-7238
Phone (770) 881-7964

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician'S Express Care at Creekstone CurrentSince Feb 27, 2019 Accepting new patients
Physicians Express Care LLC PastSince Sep 1, 2021 Accepting new patients

Locations

1780 Peachtree Pkwy
#302
Cumming, GA 30041
Phone (470) 275-6230

2730 Peachtree Industrial Blvd
Ste 101
Duluth, GA 30097
Phone (404) 548-8850

11758 Jones Bridge Rd
Johns Creek, GA 30005

900 Towne Lake Pkwy
Ste 104
Woodstock, GA 30189
Phone (770) 639-5880

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.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1558844902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 BRIARMOOR RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452112",
            "telephone_number": "770-630-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 CAMP CREEK PKWY STE 110",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303448411",
            "telephone_number": "043-447-3374",
            "fax_number": "404-344-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYBA",
        "first_name": "JORDAN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

Verify at the official NPI Registry.