NPIMap

Individual provider Active NPI

Ryan Harrison Penticuff, M.D.

  • Diagnostic Radiology Physician
  • La Jolla, CA
National Provider Identifier
1700270097
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A144248 Issued in CA
Practice address
10666 N Torrey Pines Rd
La Jolla, CA 92037-1027
Phone
(858) 554-2626
NPI assigned
Mar 24, 2015
Last updated
Jul 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A144248 CA Primary

Addresses

Primary practice location

10666 N Torrey Pines Rd
La Jolla, CA 92037-1027

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 554-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210714003292 KY Practitioner - Diagnostic Radiology 6204149909 Reassigns benefits to 3 organizations
I20220405002263 IN Practitioner - Diagnostic Radiology 6204149909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Kentucky College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northgate Medical Imaging LLCGroup PAC ID 5193744209, 43 clinicians
Radiology Associates IncGroup PAC ID 9436045259, 57 clinicians
KND Development 59 LLCGroup PAC ID 3678602802, 176 clinicians

Practice addresses (Care Compare)

Nicholasville, KY 40356
Phone (812) 949-0807

1740 Nicholasville Rd
Lexington, KY 40503-1431
Phone (859) 260-6061

1850 State St
New Albany, IN 47150-4990
Phone (812) 944-7701

256 Bassett Ave
Lexington, KY 40502-1540
Phone (502) 596-7358

807 Northgate Blvd
Priority Radiology
New Albany, IN 47150-6419
Phone (812) 949-0807

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.26 of 100Reported as group
Quality
100
Improvement activities
40
Cost
54.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A144248CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Radiology Associates Inc Diagnostic Radiology CurrentSince Jan 1, 2022 Accepting new patients
KND Development 59 LLC CurrentSince Jan 1, 2023 Accepting new patients
KND Development 59, LLC CurrentSince Jan 1, 2023 Accepting new patients
Northgate Medical Imaging LLC Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Radiology Associates Inc Diagnostic Radiology PastSince Apr 3, 2022 Accepting new patients

Locations

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

313 Federal Dr NW
Ste 20
Corydon, IN 47112
Phone (812) 734-3920

1214 Spring St
Ste 2
Jeffersonvlle, IN 47130
Phone (812) 206-8002

807 Northgate Blvd
New Albany, IN 47150
Phone (812) 206-8002

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

1025 New Moody Ln
Lagrange, KY 40031
Phone (502) 222-3335

2530 Sir Barton Way
Ste 250
Lexington, KY 40509
Phone (859) 639-0030

1740 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-6100

1313 Saint Anthony Pl
Louisville, KY 40204
Phone (502) 587-7001

Interoperability endpoints

  • Direct secure messaging: rpenticuff380006@scrippshlth.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1700270097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10666 N TORREY PINES RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371027",
            "telephone_number": "858-554-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTICUFF",
        "first_name": "RYAN",
        "middle_name": "HARRISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A144248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.