Individual provider Active NPI

Mark Ryan, PA-C

  • Physician Assistant
  • Northampton, MA
National Provider Identifier
1568020626
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6 Hatfield St
Northampton, MA 01060-1556
Phone
(413) 549-8400
NPI assigned
Jun 4, 2019
Last updated
Feb 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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 NU Primary

Addresses

Primary practice location

6 Hatfield St
Northampton, MA 01060-1556

Mailing address

6 Hatfield St
Northampton, MA 01060-1556
Phone (413) 549-8400

Other practice location 1

17 Research Dr
Amherst, MA 01002-2788
Phone (413) 549-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200401003155 MA Practitioner - Physician Assistant 1658700208 Reassigns benefits to 2 organizations

National Provider Directory

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1568020626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HATFIELD ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010601556",
            "telephone_number": "413-549-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HATFIELD ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010601556",
            "telephone_number": "413-549-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Research Dr",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "MA",
            "postal_code": "010022788",
            "country_code": "US",
            "telephone_number": "413-549-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.