Individual provider Active NPI

David I Ryan, M.D.

  • Pediatric Critical Care Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1598726242
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
L7541 Issued in TX
Practice address
9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone
(361) 960-0607
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X L7541 TX Primary
Pediatric Critical Care Medicine Physician 2080P0203X 55129 AZ

Addresses

Primary practice location

9003 E Shea Blvd
Scottsdale, AZ 85260-6709

Mailing address

3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone (361) 694-5445

Other identifiers 1

IdentifierTypeStateIssuer
148473501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240619000493 AZ Practitioner - Pediatric Medicine 6608991641 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20675NVMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
55129AZMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC CurrentSince Aug 1, 2024 Accepting new patients
Banner Childrens Banner Health Clinic LLC CurrentSince Feb 1, 2025 Accepting new patients
Banner Childrens Banner Health Clinic LLC CurrentSince Feb 1, 2025 Accepting new patients
Banner Physician Super Specialists Arizona LLC Current Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Aug 1, 2024 Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients

Locations

1435 S Alma School Rd
Chandler, AZ 85286
Phone (480) 668-1600

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1450 S Dobson Rd
Ste B220
Mesa, AZ 85202
Phone (480) 827-5044

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000

Organizations & group practices 6

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1598726242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-694-5445",
            "fax_number": "361-694-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9003 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606709",
            "telephone_number": "361-960-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "DAVID",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "L7541",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "55129",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148473501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.