Individual provider Active NPI

Joshua Everette Ryan, MD

  • Neurological Surgery Physician
  • West Islip, NY
National Provider Identifier
1750673208
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
287395 Issued in NY
Practice address
1175 Montauk Hwy Ste 6
West Islip, NY 11795-4939
Phone
(631) 422-5371
Fax
(631) 893-8012
NPI assigned
May 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X 287395 NY Primary

Addresses

Primary practice location

1175 Montauk Hwy Ste 6
West Islip, NY 11795-4939

Mailing address

1175 Montauk Hwy Ste 6
West Islip, NY 11795-4939
Phone (631) 422-5371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170821000271 NY Practitioner - Neurosurgery 1951673359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 E Main St
Suite 2B
Huntington, NY 11743-2845
Phone (631) 337-7698

1175 Montauk Hwy
Suite 6
West Islip, NY 11795-4939
Phone (631) 337-7698

270 Park Ave
Huntington, NY 11743-2787
Phone (631) 337-7698

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 337-7698

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion81
Laminectomy or laminotomy (partial removal of spine bones)25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287395NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical of Manhasset, PC Multi-Specialty CurrentSince Apr 23, 2024 Accepting new patients

Locations

4681 Veterans Memorial Hwy
Holbrook, NY 11741
Phone (631) 482-9977

110 E Main St
Ste 2B
Huntington, NY 11743
Phone (631) 337-7698

1175 Montauk Hwy
Ste 6
West Islip, NY 11795
Phone (631) 422-5371

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1750673208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 MONTAUK HWY STE 6",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954939",
            "telephone_number": "631-422-5371",
            "fax_number": "631-893-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MONTAUK HWY STE 6",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954939",
            "telephone_number": "631-422-5371",
            "fax_number": "631-893-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JOSHUA",
        "middle_name": "EVERETTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "287395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.