Individual provider Active NPI

Ryan T Lahey, PA-C

  • Physician Assistant
  • Ellsworth, KS
National Provider Identifier
1780242032
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1502245 Issued in KS
Practice address
1602 Aylward Ave
Ellsworth, KS 67439-2541
Phone
(785) 472-5029
Fax
(785) 472-5731
NPI assigned
Jun 2, 2019
Last updated
Oct 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 50869 KS
Athletic Trainer 2255A2300X
Physician Assistant 363A00000X 1502245 KS Primary

Addresses

Primary practice location

1602 Aylward Ave
Ellsworth, KS 67439-2541

Mailing address

1602 Aylward Ave
Ellsworth, KS 67439-2541
Phone (785) 472-5029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190924001008 KS Practitioner - Physician Assistant 1153651880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellsworth County Medical CenterGroup PAC ID 5395643357, 13 clinicians

Practice addresses (Care Compare)

1602 Aylward Ave
Ellsworth, KS 67439-2541
Phone (785) 810-1177

1604 Aylward Ave
Ellsworth, KS 67439-2541
Phone (785) 472-3111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50869KSMDBasic Emergency Medical Technician
1502245KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ellsworth County Medical Center CurrentSince Aug 29, 2019 Accepting new patients
Ellsworth County Medical Center CurrentSince Aug 29, 2019 Accepting new patients
Ellsworth County Medical Center Past Accepting new patients

Locations

1602 Aylward Ave
Ellsworth, KS 67439
Phone (785) 472-3111

1604 Aylward Ave
Ellsworth, KS 67439
Phone (785) 472-3111

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1780242032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 AYLWARD AVE",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-5029",
            "fax_number": "785-472-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 AYLWARD AVE",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-5029",
            "fax_number": "785-472-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHEY",
        "first_name": "RYAN",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-02",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "KS",
            "license": "50869",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1502245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, KS

Sources for this page

Verify at the official NPI Registry.