Individual provider Active NPI

Ryan Andjulo Irving, PA-C

  • Surgical Physician Assistant
  • Elmhurst, IL
National Provider Identifier
1679282198
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085009147 Issued in IL
Practice address
1200 S York St Ste 4280
Elmhurst, IL 60126-5632
Phone
(331) 221-9004
NPI assigned
Nov 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085009147 IL Primary
Physician Assistant 363A00000X 085.009147 IL

Addresses

Primary practice location

1200 S York St Ste 4280
Elmhurst, IL 60126-5632

Mailing address

4201 Winfield Rd FL 3
Warrenville, IL 60555-4025

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rirving178232@direct.edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20221228001507 IL Practitioner - Physician Assistant 1759751209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1200 S York Rd
Suite 1120
Elmhurst, IL 60126-5626
Phone (630) 527-3200

1200 S York St
Elmhurst, IL 60126-5626
Phone (331) 221-6636

155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096

177 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (630) 646-6020

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.009147ILMDPhysician Assistant
085009147ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 30, 2023 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Feb 6, 2023 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1200 S York St
Ste 4280
Elmhurst, IL 60126
Phone (331) 221-9003

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

1200 S York St
Elmhurst, IL 60126
Phone (331) 221-5678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

4201 Winfield Rd
Fl 3
Warrenville, IL 60555

Interoperability endpoints

  • Direct secure messaging: rirving178232@direct.edward.org

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": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1679282198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD FL 3",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST STE 4280",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265632",
            "telephone_number": "331-221-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVING",
        "first_name": "RYAN",
        "middle_name": "ANDJULO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-23",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085009147",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009147",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rirving178232@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 S York St Ste 4280",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601265632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.