Individual provider Active NPI

Skylar Kristine Ryan, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1639729247
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1008 E McDowell Rd Ste a
Phoenix, AZ 85006-2603
Phone
(602) 358-8588
Fax
(602) 688-6991
NPI assigned
Sep 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8251 AZ
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1008 E McDowell Rd Ste a
Phoenix, AZ 85006-2603

Mailing address

2960 N Lainey LN
Buckeye, AZ 85396-7326
Phone (813) 310-2524

Other practice location 1

1151 N Gilbert Rd
Mesa, AZ 85203-5127
Phone (602) 358-8588

Other practice location 2

1919 E McKellips Rd Ste 106
Mesa, AZ 85203-2855
Phone (602) 358-8588

Other practice location 3

2222 E Highland Ave Ste 205
Phoenix, AZ 85016-4876
Phone (602) 358-8588

Other practice location 4

7330 N 16th St Ste B101
Phoenix, AZ 85020-5274
Phone (602) 358-8588

Other practice location 5

10555 N Tatum Blvd Ste A101
Paradise Valley, AZ 85253-1096
Phone (602) 358-8588

Other practice location 6

702 E Bell Rd Ste 119
Phoenix, AZ 85022-6639
Phone (602) 358-8588

Other practice location 7

10585 N Tatum Blvd Ste D130
Paradise Valley, AZ 85253-1073
Phone (602) 358-8588

Other identifiers 1

IdentifierTypeStateIssuer
096100MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HIE Health Information Exchange (HIE)

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201230002557 AZ Practitioner - Physician Assistant 3173936622 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kelly H Roy MD PCGroup PAC ID 3476526724, 28 clinicians

Practice addresses (Care Compare)

1151 N Gilbert Rd
Mesa, AZ 85203-5127
Phone (602) 358-8588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8251AZMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth-Fastmed Ambulatory Holdings LLC CurrentSince Dec 21, 2020 Accepting new patients
Honorhealth-Fastmed Ambulatory Holdings LLC CurrentSince Dec 21, 2020 Accepting new patients
WD Recovery and Wellness Center, LLC Past Accepting new patients

Locations

415 N Val Vista Dr
Ste 101
Mesa, AZ 85213
Phone (480) 654-5661

5259 W Indian School Rd
Ste 100
Phoenix, AZ 85031
Phone (623) 888-5101

8260 W Indian School Rd
Ste 1
Phoenix, AZ 85033
Phone (623) 846-7122

2720 W Baseline Rd
Tempe, AZ 85283
Phone (602) 777-6000

Interoperability endpoints

  • Direct secure messaging: skylar.ryan.1@2541.direct.athenahealth.com

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": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1639729247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 N LAINEY LN",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853967326",
            "telephone_number": "813-310-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 E MCDOWELL RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062603",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 N Gilbert Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852035127",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1919 E McKellips Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852032855",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 E Highland Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164876",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7330 N 16th St Ste B101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850205274",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10555 N Tatum Blvd Ste A101",
            "address_purpose": "LOCATION",
            "city": "Paradise Valley",
            "state": "AZ",
            "postal_code": "852531096",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 E Bell Rd Ste 119",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850226639",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "fax_number": "602-688-6991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10585 N Tatum Blvd Ste D130",
            "address_purpose": "LOCATION",
            "city": "Paradise Valley",
            "state": "AZ",
            "postal_code": "852531073",
            "country_code": "US",
            "telephone_number": "602-358-8588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SKYLAR",
        "middle_name": "KRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8251",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096100",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIE",
            "affiliation": "N",
            "endpointDescription": "HIE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIE",
            "address_1": "1008 E McDowell Rd Ste A",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850062603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.