Individual provider Active NPI

Ryan Kendall Harris, MD

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1568758167
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME120691 Issued in FL
Practice address
21 W Columbia St
Orlando, FL 32806-2028
Phone
(321) 841-6600
Fax
(321) 841-4085
NPI assigned
Jun 22, 2011
Last updated
Nov 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME120691 FL Primary

Addresses

Primary practice location

21 W Columbia St
Orlando, FL 32806-2028

Mailing address

21 W Columbia St
Orlando, FL 32806-2028
Phone (321) 841-6600

Other identifiers 2

IdentifierTypeStateIssuer
ME120691OtherFLMEDICAL LICENSE
012451900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821002447 FL Practitioner - Internal Medicine 6901041987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1414 Kuhl Ave
Orlando, FL 32806-2008
Phone (407) 841-5111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME120691FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2014 Accepting new patients
Orlando Physicians Network Inc Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients

Locations

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rharris26033@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1568758167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062028",
            "telephone_number": "321-841-6600",
            "fax_number": "321-841-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062028",
            "telephone_number": "321-841-6600",
            "fax_number": "321-841-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "RYAN",
        "middle_name": "KENDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME120691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME120691",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012451900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.