Corey Douglas Ryan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ORT011296 Issued in NY

Practice address

53 Public SQ
Watertown, NY 13601-2174

Phone

(315) 681-6379

NPI assigned

Jun 6, 2025

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/Freedom_CEP

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.

• Costello Eye Physicians & Surgeons, PLLC

  • Ophthalmology Physician
  • Oneida, NY
  • NPI 1699785832

  NY, Optometrist

  Medicare reassignment Care Compare group NPD
• David a Ewing-Chow, MD, PLLC

  • Ophthalmology Physician
  • Watertown, NY
  • NPI 1609128107
  NPD (past)

Specialty

Optometry

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Costello Eye Physicians and Surgeons PLLC 11 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1699669291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PUBLIC SQ STE 102",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012674",
            "telephone_number": "315-681-6379",
            "fax_number": "315-681-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 PUBLIC SQ",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012174",
            "telephone_number": "315-681-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "COREY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-06",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "ORT011296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Lynne Russell, RN
• Olivia Russell
• Jennifer H Rutledge, OTR/L
• Mark Alan Rutledge, OTR
• Carlice Cecil Ruttan II, LCSW
• S.T.a.T Communications, Inc
• Evette Sadler, MD
• Samantha M Salisbury, LCSW
• Samaritan Home Health Inc
• Samaritan Keep Nursing Home Inc

• All providers in Watertown, NY
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.