Active NPI
Patricia Ann Ryan, DO
- Family Medicine Physician
- East Lansing, MI
National Provider Identifier
1639150683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101012513
- Practice address
- 463 E Circle Dr
East Lansing, MI 48824-7505 - Phone
- (517) 883-6546
- Fax
- (517) 432-9460
- NPI assigned
- Nov 8, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101012513 | MI | Primary |
Addresses
Primary practice location
463 E Circle Dr
East Lansing, MI 48824-7505
Mailing address
463 E Circle Dr
East Lansing, MI 48824-7505
Phone (517) 883-6546
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0851900115 | Other | MI | BLUE CROSS BLUE SHIELD |
| 0101936 | Other | MI | PHYSICIANS HEALTH PLAN |
| 080D410020 | Other | MI | BLUE CARE NETWORK |
| 1639150683 | Medicaid | MI | |
| 5180305 | Other | MI | AETNA |
| 080D410020 | Other | MI | BLUE CROSS BLUE SHIELD |
| 080D410020 | Other | MI | COMMUNITY BLUE |
| 1014874 | Other | MI | HEALTH ADVANTAGE NETWORK |
| 080D410020 | Other | MI | BLUE CHOICE |
| G21314 | Other | MI | HEALTH NET FED SERVICES |
| 1014874 | Other | MI | MCLAREN HEALTH PLAN |
| 4748682 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101012513 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415318400000",
"number": "1639150683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "463 E CIRCLE DR",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488247505",
"telephone_number": "517-883-6546",
"fax_number": "517-432-9460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "463 E CIRCLE DR",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488247505",
"telephone_number": "517-883-6546",
"fax_number": "517-432-9460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2014-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101012513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0851900115",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS HEALTH PLAN",
"identifier": "0101936",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "080D410020",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1639150683",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5180305",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "080D410020",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY BLUE",
"identifier": "080D410020",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ADVANTAGE NETWORK",
"identifier": "1014874",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "080D410020",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET FED SERVICES",
"identifier": "G21314",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH PLAN",
"identifier": "1014874",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4748682",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.