Timothy Wayne Ryschon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

43417 Issued in CO

Practice address

2 Portofino Dr Ste 2107
Pensacola Beach, FL 32561-2503

Phone

(720) 206-7058

Fax

(866) 614-6108

NPI assigned

Jun 9, 2005

Last updated

Sep 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ, FL, TN, TX4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• Hospital Medicine Services of FL, LLC

  • Hospitalist Physician
  • Aventura, FL
  • NPI 1710684857
  Medicare reassignment NPD
• Hospital Physician Services of Florida PA

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1558718635
  Medicare reassignment NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment NPD
• Phoenix Children's Hospital

  dba Phoenix Children's Medical Group

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Texas PLLC

  • Emergency Medicine Physician
  • Killeen, TX
  • NPI 1518475557
  Medicare reassignment NPD
• Tri-Cities Regional Emergency Physicians, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1063950046
  Medicare reassignment NPD
• Dox4All PC

  • General Practice Physician
  • Loveland, CO
  • NPI 1922464742
  NPD (past) Authorized official
• Phoenix Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Phoenix Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1679703441
  NPD
• Blue Job Emergency Physicians LLC

  • Emergency Medicine Physician
  • Fort Walton Beach, FL
  • NPI 1457760142
  NPD (past)
• Florida Em-I Medical Services, PA

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1083046049
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1730183526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PORTOFINO DR STE 2106",
            "city": "PENSACOLA BEACH",
            "state": "FL",
            "postal_code": "325612503",
            "telephone_number": "720-206-7058",
            "fax_number": "866-614-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PORTOFINO DR STE 2107",
            "city": "PENSACOLA BEACH",
            "state": "FL",
            "postal_code": "325612503",
            "telephone_number": "720-206-7058",
            "fax_number": "866-614-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYSCHON",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "67784",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "44159",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "43417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "611583",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02783533",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark W. Ernest, M.D.
• Diana Galvis, INTERPRETER
• Mauricio Garzon, INTERPRETER
• Gulf Coast Mobile Medical Care LLC (Gulf Coast Mobile Medical Care)
• Bryan Joseph Leger, CRNA
• Michael Edward Strait

• Emergency Medicine Physician in Pensacola Beach, FL
• Providers in Pensacola Beach, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.