Ryan Thomas Maccracken

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209027569 Issued in IL

Practice address

108 Larch Rd
Frankfort, IL 60423-1513

Phone

(815) 823-4108

NPI assigned

Sep 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Premier Anesthesia of Illinois Professional CorporationGroup PAC ID 1254826175, 42 clinicians

Novus Illinois Service CorporationGroup PAC ID 6901293786, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Novus Illinois Service Corporation

  • Anesthesiology Physician
  • Kankakee, IL
  • NPI 1295491744

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Premier Anesthesia of Illinois Professional Corporation

  • Anesthesiology Physician
  • Kankakee, IL
  • NPI 1932089778

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

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

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1609546324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 LARCH RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231513",
            "telephone_number": "815-823-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LARCH RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231513",
            "telephone_number": "815-823-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCRACKEN",
        "first_name": "RYAN",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209027569",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041462258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc.
• Luxury Home Healthcare
• Sarah Ama-Biamah Lyons, LSW
• Michael Lysaught
• Josephine F Lytton
• Colleen Elizabeth Maguire, OTR/L
• Gabrielle Malec
• Manjeev Malhotra, DDS
• Nadir Mallick, MD
• Justin Manaparambil, PHARMD

• Certified Registered Nurse Anesthetist in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.