Individual provider Active NPI

Ryan Palenske, DO

  • Emergency Medicine Physician
  • Springfield, MO
National Provider Identifier
1760011654
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2024018625 Issued in MO
Practice address
3801 S National Ave
Springfield, MO 65807-5210
Phone
(417) 269-6000
Fax
(417) 269-6573
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2024018625 MO Primary

Addresses

Primary practice location

3801 S National Ave
Springfield, MO 65807-5210

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673
Phone (417) 730-6430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MO2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230621003092 PA Practitioner - Emergency Medicine 1658794987 Reassigns benefits to 2 organizations
I20240708003448 MO Practitioner - Emergency Medicine 1658794987 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024018625MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture LLC CurrentSince Jul 1, 2023 Accepting new patients
Geisinger Clinic Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Lester E. Cox Medical Centers Current Accepting new patients
Cox-Monett Hospital, Inc. Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Jul 1, 2023 Accepting new patients
Cox-Monett Hospital, Inc. Current Accepting new patients
Lester E Cox Medical Centers Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Geisinger Clinic CurrentSince Jul 1, 2023 Accepting new patients
Geisinger-HM Joint Venture, LLC Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Aug 1, 2024 Accepting new patients

Locations

1000 E US Highway 60
Monett, MO 65708
Phone (417) 354-1269

3801 S National Ave
Fl 5
Springfield, MO 65807

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

100 N Academy Ave
Danville, PA 17822

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

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

Organizations & group practices 11

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1760011654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-6000",
            "fax_number": "417-269-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALENSKE",
        "first_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2024018625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.