Individual provider Active NPI

Ryan Kondo Cunningham, M.D.

  • Diagnostic Radiology Physician
  • Danville, PA
National Provider Identifier
1720399546
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD457330 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-5103
Phone
(570) 271-6301
NPI assigned
Jun 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT197836 PA
Diagnostic Radiology Physician 2085R0202X MT197836 PA
Diagnostic Radiology Physician 2085R0202X MD457330 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-5103

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160901001329 PA Practitioner - Diagnostic Radiology 8426369323 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD457330PAMDDiagnostic Radiology Physician
MT197836PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture LLC Internal Medicine CurrentSince Jul 13, 2020 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Jul 13, 2020 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Jul 13, 2020 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger-HM Joint Venture, LLC Diagnostic Radiology Current Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Jul 13, 2020 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

1824 E 3rd St
Williamsport, PA 17701
Phone (570) 322-4422

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1720399546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178225103",
            "telephone_number": "570-271-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "RYAN",
        "middle_name": "KONDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT197836",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT197836",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD457330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.