Olivia Suzanne Ryan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71010706A Issued in IN

Practice address

621 Memorial Dr Ste 502
South Bend, IN 46601-1075

Phone

(574) 647-5875

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedics-Indianapolis IncGroup PAC ID 7416860663, 357 clinicians

Fort Wayne Orthopaedics, LLCGroup PAC ID 7618965286, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Orthopaedic Hospital of Lutheran Health Networ Hospital, Ft Wayne, IN, CCN 150168
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017

Merit-based Incentive Payment System (MIPS)

Final score

83.85 of 100Reported as group

Promoting interoperability

81

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: olicia.ryan.p1@direct.fwortho.nextgenshare.com

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.

• Fort Wayne Orthopaedics LLC

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
  • NPI 1497758429

  Family, IN

  Medicare reassignment Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1336252451

  IN

  Medicare reassignment Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Terre Haute, IN
  • NPI 1285433953
  Care Compare group NPD
• Fort Wayne Orthopaedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1033320510
  Care Compare group
• Fort Wayne Orthopaedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Warsaw, IN
  • NPI 1982060190
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Kokomo, IN
  • NPI 1003615774
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Westfield, IN
  • NPI 1013371277
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1073622015
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1134431125
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Greenfield, IN
  • NPI 1194524876
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Lafayette, IN
  • NPI 1225737950
  Care Compare group
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Warsaw, IN
  • NPI 1316899768
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335

  Hospital

  Care Compare affiliation
• Lutheran Musculoskeletal Center LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1174706576

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1568065258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 502",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011075",
            "telephone_number": "574-647-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "OLIVIA",
        "middle_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F06201190",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010706A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "236040361",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300046192",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oryan@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "621 Memorial Dr Ste 502",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Alexis Russell, DNP, APRN, FNP-BC
• Patrick W Russell, D.O.
• Robert J Rust, M.D.
• Sofia Rutledge, DPT
• Karissa D Ryan, LMHC
• Allison Rykse, DPT
• Mary Ryman
• David M Sabato, MD
• Leslie A Sackett, LCSW
• N.David Saddawi, M.D

• All providers in South Bend, IN
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.