Individual provider Active NPI

Ryan Lamont Clikeman, AG-ACNP

  • Acute Care Nurse Practitioner
  • Abington, PA
National Provider Identifier
1649813510
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP020352 Issued in PA
Practice address
1200 Old York Rd
Abington, PA 19001-3720
Phone
(215) 481-2000
NPI assigned
Oct 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP020352 PA Primary

Addresses

Primary practice location

1200 Old York Rd
Abington, PA 19001-3720

Mailing address

7113 Cherokee St
Philadelphia, PA 19119-2962
Phone (215) 262-1857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20201125001487 PA Practitioner - Nurse Practitioner 3476964370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-9936

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP020352PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Jan 21, 2021 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Jan 21, 2021 Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1649813510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7113 CHEROKEE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192962",
            "telephone_number": "215-262-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIKEMAN",
        "first_name": "RYAN",
        "middle_name": "LAMONT",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP020352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, PA

Sources for this page

Verify at the official NPI Registry.