Individual provider Active NPI

Ryan Zane, MD

  • Public Health & General Preventive Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1669534293
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
G58459 Issued in CA
Practice address
799 E Rialto Ave
San Bernardino, CA 92415-1005
Phone
(909) 383-3060
Fax
(909) 383-3212
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X G58459 CA
Public Health & General Preventive Medicine Physician 2083P0901X G58459 CA Primary

Addresses

Primary practice location

799 E Rialto Ave
San Bernardino, CA 92415-1005

Mailing address

799 E Rialto Ave
San Bernardino, CA 92415-1005
Phone (909) 383-3060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20090921000012 CA Practitioner - Family PracticePractitioner - Preventive Medicine 9133275910 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G58459CAMDPublic Health or Welfare Agency

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Public Health Or Welfare Current Accepting new patients
County of San Bernardino Public Health Or Welfare CurrentSince Jul 1, 2009 Accepting new patients
County of San Bernardino CurrentSince Jul 1, 2009 Accepting new patients
County of Riverside CurrentSince Jan 28, 2015 Accepting new patients
County of Riverside Public Health Or Welfare CurrentSince Jan 28, 2015 Accepting new patients
County of San Bernardino Current Accepting new patients
County of San Bernardino Public Health Or Welfare Past Accepting new patients

Locations

303 E Mountain View St
Barstow, CA 92311
Phone (760) 256-4705

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

800 E Lugonia Ave
Ste F
Redlands, CA 92374
Phone (855) 422-8029

351 N Mountain View Ave
Rm 303
Sn Bernrdno, CA 92415

799 E Rialto Ave
Sn Bernrdno, CA 92408
Phone (909) 383-3005

Interoperability endpoints

  • Direct secure messaging: rzane96858@direct.llu.edu
  • Direct secure messaging: jsvinson@yourcarecommunity.org

Organizations & group practices 7

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1669534293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 E RIALTO AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151005",
            "telephone_number": "909-383-3060",
            "fax_number": "909-383-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 E RIALTO AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151005",
            "telephone_number": "909-383-3060",
            "fax_number": "909-383-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANE",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "CA",
            "license": "G58459",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "G58459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.