Samantha Nicole Ryan, ARNP
Individual provider Active NPI Geriatric Medicine (Family Medicine) Physician · Cedar Rapids, IA
NPI 1760264758 · NPPES record last updated Oct 16, 2023
Key facts
- NPI
- 1760264758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- H176750 (IA)
- Practice address
- 1224 13TH St NW
Cedar Rapids, IA 52405-2404 - Phone
- (319) 365-9171
- NPI assigned
- Oct 16, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iowa Physicians Clinic Medical Foundation
Practice addresses (Care Compare)
1224 13TH St NW
Cedar Rapids, IA 52405-2404
Phone (319) 743-6235
2375 Edgewood Rd SW
Cedar Rapids, IA 52404-4736
Phone (319) 396-1983
4480 Utica Ridge Rd
Bettendorf, IA 52722-1644
6911 C Ave NE
Fmly Med Bow Woods
Cedar Rapids, IA 52402-1349
Phone (319) 832-1463
Hospital & facility affiliations
- Essence of Life Hospice
- Hospice of Mercy
- Suncrest Hospice
- St Lukes Hospital
- Meth-Wick Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240213000760 | IA | Practitioner - Nurse Practitioner | 3274976691 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H176750 | IA | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Iowa Physicians Clinic Medical Foundation | Geriatric Medicine | Current |
Accepting new patients |
Locations
4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
1224 13th St NW
Cedar Rapids, IA 52405
Phone (319) 365-9171
6911 C Ave NE
Cedar Rapids, IA 52402
Phone (319) 832-1463
1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161
Interoperability endpoints
- sryan106865@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | H176750 | IA | Yes |
Addresses
Primary practice location
1224 13TH St NW
Cedar Rapids, IA 52405-2404
Mailing address
1011 Acacia Dr NE
Cedar Rapids, IA 52402-6766
Other providers in Cedar Rapids, IA
- Tiyanna Russell
- Madia Chowdhury Russillo
- Ruth Christine Gonzalez DDS PC
- Serena Lynann Ruth
- Philip Thomas Ryan
- Thomas Joseph Ryan IV
- Eric Ryder
- William R. Ryder
- Connie Rystrom
- S.T.L. Care Company
All providers in Cedar Rapids, IA · Geriatric Medicine (Family Medicine) Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.