Individual provider Active NPI

Ryan L. Zollett, D.O.

  • Anesthesiology Physician
  • Dayton, OH
National Provider Identifier
1790904019
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
34.008249 Issued in OH
Practice address
1530 Needmore Rd
Suite 101
Dayton, OH 45414-3969
Phone
(937) 396-2602
Fax
(937) 395-3682
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34.008249 OH Primary

Addresses

Primary practice location

1530 Needmore Rd
Suite 101
Dayton, OH 45414-3969

Mailing address

1530 Needmore Rd
Suite 101
Dayton, OH 45414-3969
Phone (937) 396-2602

Other identifiers 1

IdentifierTypeStateIssuer
2457443MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040707001581 OH Practitioner - AnesthesiologyPractitioner - Internal Medicine 1951389998 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.008249OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Anesthesia, LLC Anesthesiology CurrentSince Feb 23, 2009 Accepting new patients
Middletown Anesthesia Consultants Inc Anesthesiology Past Accepting new patients
Premier Anesthesia Consultants, LLC Anesthesiology Past Accepting new patients

Locations

4340 Clyo Rd
#200
Dayton, OH 45459
Phone (937) 396-2602

1530 Needmore Rd
Ste 101
Dayton, OH 45414
Phone (937) 396-2602

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1790904019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD",
            "address_2": "SUITE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143969",
            "telephone_number": "937-396-2602",
            "fax_number": "937-395-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD",
            "address_2": "SUITE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143969",
            "telephone_number": "937-396-2602",
            "fax_number": "937-395-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLETT",
        "first_name": "RYAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34.008249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2457443",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.