Individual provider Active NPI

Ryan Chan, PA

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1669133641
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61499669 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 223-6374
NPI assigned
Jan 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Physician Assistant 363AS0400X PA61499669 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

PO Box 741515
Los Angeles, CA 90074-1515
Phone (206) 223-6374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240112001412 WA Practitioner - Physician Assistant 3173974292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

33501 1St Way S
Federal Way, WA 98003-6208
Phone (253) 838-2400

4575 Sand Point Way NE
Suite 108
Seattle, WA 98105-3999
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Hospital & facility affiliations

  • Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61499669WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Jan 25, 2024 Accepting new patients
Virginia Mason Medical Center CurrentSince Jan 25, 2024 Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

Organizations & group practices 3

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1669133641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900741515",
            "telephone_number": "206-223-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-03",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61499669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.