Active NPI
Ryan Perry, MBA, MMS, PA-C
- Physician Assistant
- Fresno, CA
National Provider Identifier
1629669429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA59118
- Practice address
- 2615 E Clinton Ave
Fresno, CA 93703-2223 - Phone
- (559) 225-6100
- NPI assigned
- Feb 3, 2021
- Last updated
- Jan 23, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA59118 | CA | Primary |
Addresses
Primary practice location
2615 E Clinton Ave
Fresno, CA 93703-2223
Mailing address
10753 E Estro Bay
Clovis, CA 93619-4726
Phone (760) 535-2304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA59118 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adult and Pediatric Orthopaedic Specialists a Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Orange, CA
- NPI 1902831514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642896000000",
"number": "1629669429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10753 E ESTRO BAY",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936194726",
"telephone_number": "760-535-2304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 E CLINTON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937032223",
"telephone_number": "559-225-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "RYAN",
"credential": "MBA, MMS, PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-03",
"last_updated": "2022-01-23",
"certification_date": "2021-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA59118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.