NPIMap

Individual provider Active NPI

Ryder P Gwinn, MD

  • Neurological Surgery Physician
  • Seattle, WA
National Provider Identifier
1700945607
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD00043991 Issued in WA
Practice address
801 Broadway
Ste 901
Seattle, WA 98122-4396
Phone
(206) 386-3880
Fax
(206) 386-3882
NPI assigned
Dec 6, 2006
Last updated
May 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD00043991 WA Primary

Addresses

Primary practice location

801 Broadway
Ste 901
Seattle, WA 98122-4396

Mailing address

PO Box 84026
Seattle, WA 98124-8426

Other practice location 1

550 17th Ave Ste 540
Seattle, WA 98122-4470
Phone (206) 320-4145

Other identifiers 2

IdentifierTypeStateIssuer
0187914OtherWALABOR AND INDUSTRIES
8403511MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgwinn1041805@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 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
I20040824000447 WA Practitioner - Neurosurgery 1557335783 Reassigns benefits to 2 organizations
I20171207002981 TX Practitioner - Neurosurgery 1557335783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Un of California, Irvine, College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1135 116TH Ave NE
Suite 500
Bellevue, WA 98004-4627
Phone (425) 635-6560

12039 NE 128TH St
Suite 500
Kirkland, WA 98034-3029
Phone (425) 899-3139

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion52
Laminectomy or laminotomy (partial removal of spine bones)18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Jan 1, 2021 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Oct 31, 2017 Accepting new patients
King County Public Hospital District No 2 CurrentSince Jan 1, 2021 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Feb 1, 2021 Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

1135 116th Ave NE
Ste 500
Bellevue, WA 98004
Phone (425) 454-3938

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

12039 NE 128th St
Ste 500
Kirkland, WA 98034
Phone (425) 899-1220

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

Organizations & group practices 8

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 4

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1700945607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84026",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981248426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY",
            "address_2": "STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224396",
            "telephone_number": "206-386-3880",
            "fax_number": "206-386-3882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 17th Ave Ste 540",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224470",
            "country_code": "US",
            "telephone_number": "206-320-4145",
            "fax_number": "206-320-8149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWINN",
        "first_name": "RYDER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "MD00043991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0187914",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8403511",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgwinn1041805@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 17th Ave Ste 540",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981224470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.