Individual provider Active NPI

Ryan McDaniel, PA-C

  • Surgical Physician Assistant
  • Medford, OR
National Provider Identifier
1720598287
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA201374 Issued in OR
Practice address
2780 E Barnett Rd Ste 200
Medford, OR 97504-8674
Phone
(541) 779-6250
Fax
(541) 608-2535
NPI assigned
Oct 10, 2017
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA201374 OR Primary

Addresses

Primary practice location

2780 E Barnett Rd Ste 200
Medford, OR 97504-8674

Mailing address

2780 E Barnett Rd Ste 200
Medford, OR 97504-8674
Phone (541) 779-6250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171129000455 PA Practitioner - Physician Assistant 5395002349 Reassigns benefits to 1 organization
I20200807000645 OR Practitioner - Physician Assistant 5395002349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oregon Orthopedics IncGroup PAC ID 1456256528, 64 clinicians

Practice addresses (Care Compare)

2780 E Barnett Rd
Suite 200
Medford, OR 97504-8674
Phone (541) 779-6250

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Oct 23, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 23, 2017 Accepting new patients
Southern Oregon Orthopedics Inc CurrentSince Sep 1, 2020 Accepting new patients

Locations

2780 E Barnett Rd
Ste 200
Medford, OR 97504
Phone (541) 779-6250

1250 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 435-1003

2100 Mack Blvd
Fl 4
Allentown, PA 18103

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Interoperability endpoints

  • Direct secure messaging: rmcdaniel1371012@oc.providencedirect.org

Organizations & group practices 4

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 1

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1720598287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250",
            "fax_number": "541-608-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 E BARNETT RD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048674",
            "telephone_number": "541-779-6250",
            "fax_number": "541-608-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA201374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.