NPIMap

Individual provider Active NPI

Ryan D Crouch, D.O.

  • Internal Medicine Physician
  • Grand Island, NE
National Provider Identifier
1790724201
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
118 Issued in NE
Practice address
3563 Prairieview St Ste 200
Grand Island, NE 68803-4442
Phone
(308) 382-2010
Fax
(308) 382-9549
NPI assigned
Jun 6, 2006
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 118 NE Primary

Addresses

Primary practice location

3563 Prairieview St Ste 200
Grand Island, NE 68803-4442

Mailing address

3563 Prairieview St Ste 200
Grand Island, NE 68803-4442
Phone (308) 382-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071115000530 NE Practitioner - Internal Medicine 3971592874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

3533 Prairieview St
Grand Island, NE 68803-4409
Phone (308) 675-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy50
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions25
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Island Regional Medical Center CurrentSince Jun 1, 2020 Accepting new patients
Bryan Physician Network Internal Medicine CurrentSince Oct 29, 2019 Accepting new patients
Integrated Cardiology Group LLC CurrentSince Jul 1, 2022 Accepting new patients
Grand Island Regional Medical Center Past Accepting new patients

Locations

3533 Prairieview St
Grand Island, NE 68803
Phone (308) 675-4557

3563 Prairieview St
Ste 200
Grand Island, NE 68803
Phone (308) 318-6290

3563 Prairieview St
Ste 200A
Grand Island, NE 68803

800 N Alpha St
Grand Island, NE 68803
Phone (308) 382-2010

2222 S 16th St
Ste 400A
Lincoln, NE 68502
Phone (402) 475-8877

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

Interoperability endpoints

  • Direct secure messaging: rcrouch51812@hisp.bryanhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grand Island Regional Medical CenterGrand Island, NE, CCN 280139 Hospital Corporate Officer
Corporate Director		 Jan 24, 2023
Feb 18, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1790724201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3563 PRAIRIEVIEW ST STE 200",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034442",
            "telephone_number": "308-382-2010",
            "fax_number": "308-382-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3563 PRAIRIEVIEW ST STE 200",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034442",
            "telephone_number": "308-382-2010",
            "fax_number": "308-382-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "RYAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.