Individual provider Active NPI

Patrick Michael Ryan, MD

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1730406349
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q5554 Issued in TX
Practice address
4502 E. 41St Street
University of Oklahoma, College of Community Medicine
Tulsa, OK 74135
Phone
(918) 660-3416
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X Q5554 TX
Pediatrics Physician 208000000X Q5554 TX Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X Q5554 TX

Addresses

Primary practice location

4502 E. 41St Street
University of Oklahoma, College of Community Medicine
Tulsa, OK 74135

Mailing address

3112 Crestwood Lane
Glenview, IL 60025
Phone (847) 998-5859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20220210000227 LA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2264748656 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q5554TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Nov 9, 2021 Accepting new patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Aug 29, 2024 Accepting new patients
Children'S Hospital Emergency Medicine CurrentSince Nov 9, 2021 Accepting new patients
WJH Physician Services Emergency Medicine CurrentSince Nov 6, 2021 Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

1111 Medical Center Blvd
Ste S250
Marrero, LA 70072
Phone (504) 347-5511

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

1100 Poydras St
Ste 2500
New Orleans, LA 70163
Phone (504) 527-9953

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1730406349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 CRESTWOOD LANE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60025",
            "telephone_number": "847-998-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E. 41ST STREET",
            "address_2": "UNIVERSITY OF OKLAHOMA, COLLEGE OF COMMUNITY MEDICINE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74135",
            "telephone_number": "918-660-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q5554",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q5554",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "Q5554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.