Organization Active NPI

Daniel J Ryan MD PC

  • Ophthalmology Physician
  • Flint, MI
National Provider Identifier
1710043641
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DANIEL J RYAN MD PC
Practice address
1113 Villa Linde CT
Flint, MI 48532-3410
Phone
(810) 733-1214
Fax
(810) 733-3011
NPI assigned
Dec 28, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Daniel J Ryan, M.D.NPI 1629040068
Title
President
Phone
(810) 733-1214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1113 Villa Linde CT
Flint, MI 48532-3410

Mailing address

1113 Villa Linde CT
Flint, MI 48532-3410
Phone (810) 733-1214

Other identifiers 13

IdentifierTypeStateIssuer
DR068574OtherBLUE CHOICE THRU BCN
07308OtherM CARE
1004688OtherMCLAREN HEALTH ADVANTAGE
180044733OtherRR MEDICARE
1004688OtherMCLAREN HEALTH PLAN
1867250OtherFIRST HEALTH
7650396OtherAETNA
4218962MedicaidMI
0988882OtherMIHEALTH PLUS
0988882OtherGENESEE HEALTH PLAN
1802505282OtherMIBCBS
1802505282OtherBLUE CROSS NETWORK
C7308OtherKIDS CARE OF MI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040901000457 MI Part B Supplier - Clinic/Group Practice 6901871011 Receives reassigned benefits from 1 practitioner
Practice locations: Flint, MI
O20100930047775 MI DME Supplier - Physician - OptometristDME Supplier - Optician 6901871011 Practice locations: Flint, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Daniel J Ryan MD PC1113 Villa Linde CT, Flint, MI 48532-3410(810) 733-1214 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Jun 10, 2002

National Provider Directory

National Provider Directory

Locations

1113 Villa Linde Ct
Flint, MI 48532
Phone (810) 732-6231

1113 Villa Linde Ct
Bldg 3
Flint, MI 48532
Phone (810) 733-1214

1113 Villa Linde Ct
Bldg 35
Flint, MI 48532
Phone (810) 733-1214

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/K5AZLDonMdOUURhD3rPUNxDoRLOgChcj/

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1710043641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 VILLA LINDE CT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323410",
            "telephone_number": "810-733-1214",
            "fax_number": "810-733-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 VILLA LINDE CT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323410",
            "telephone_number": "810-733-1214",
            "fax_number": "810-733-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL J RYAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-733-1214",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE THRU BCN",
            "identifier": "DR068574",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M CARE",
            "identifier": "07308",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH ADVANTAGE",
            "identifier": "1004688",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "180044733",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1004688",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1867250",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7650396",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4218962",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "0988882",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENESEE HEALTH PLAN",
            "identifier": "0988882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1802505282",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NETWORK",
            "identifier": "1802505282",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIDS CARE OF MI",
            "identifier": "C7308",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.