NPIMap

Individual provider Active NPI

Michael Ryder, D.O.

  • Family Medicine Physician
  • Medford, NY
National Provider Identifier
1659598589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
222186 Issued in NY
Practice address
1743 N Ocean Ave
Medford, NY 11763-2649
Phone
(631) 758-3100
Fax
(631) 758-3168
NPI assigned
Apr 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 222186 NY Primary

Addresses

Primary practice location

1743 N Ocean Ave
Medford, NY 11763-2649

Mailing address

1743 N Ocean Ave
Medford, NY 11763-2649
Phone (631) 758-3100

Other identifiers 1

IdentifierTypeStateIssuer
02370125MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223000258 NY Practitioner - Family Practice 8820984446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1743 N Ocean Ave
Medford, NY 11763-2649
Phone (631) 758-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Feb 1, 2023 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
St. Catherine of Siena Medical Center Past Accepting new patients
Smithtown Health Care Management Past Accepting new patients

Locations

500 Commack Rd
Ste E
Commack, NY 11725
Phone (631) 435-0110

1743 N Ocean Ave
Medford, NY 11763
Phone (516) 758-3100

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mryder15311@direct-chsli.net

Organizations & group practices 4

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659598589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 N OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-758-3100",
            "fax_number": "631-758-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 N OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-758-3100",
            "fax_number": "631-758-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "222186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02370125",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.