Youngwon Ryu

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR.0076308 Issued in CO

Practice address

18511 Highlander Medics St
Fort Bliss, TX 79906-5327

Phone

(915) 742-0399

Fax

(915) 742-0724

NPI assigned

Jun 25, 2024

Last updated

Sep 4, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1669216594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18511 HIGHLANDER MEDICS ST",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799065327",
            "telephone_number": "915-742-0399",
            "fax_number": "915-742-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18511 HIGHLANDER MEDICS ST",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799065327",
            "telephone_number": "915-742-0399",
            "fax_number": "915-742-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYU",
        "first_name": "YOUNGWON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-25",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0076308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simone Rosson, LCSW
• Ekaterina Rout
• Zachary Samuel Rubin
• Ricardo Ruiz
• Christine Ruvalcaba, APRN-CP
• Michael Emile Salloum, DO
• Andrew Salomon, MD
• Rocio Erika Samaniego
• Riley Sanocki, DDS
• Elsa Santillano, OTR

• Internal Medicine Physician in Fort Bliss, TX
• Providers in Fort Bliss, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.