Individual provider Active NPI

Michael Joseph Ryan, MD

  • Interventional Cardiology Physician
  • Vancouver, WA
National Provider Identifier
1811151723
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD60829836 Issued in WA
Practice address
700 NE 87TH Ave
Vancouver, WA 98664
Phone
(608) 822-7783
Fax
(360) 604-1753
NPI assigned
Jul 10, 2008
Last updated
Jun 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 54980 CO
Cardiovascular Disease Physician 207RC0000X MD60829836 WA
Interventional Cardiology Physician 207RI0011X 54980 CO
Interventional Cardiology Physician 207RI0011X MD60829836 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave
Vancouver, WA 98664

Mailing address

2643 Patterson Rd
Suite 605
Grand Junction, CO 81506-1936
Phone (970) 298-2482

Other identifiers 1

IdentifierTypeStateIssuer
2100218MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20180719002775 WA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4587976600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Loyola University of Chicago, Stritch School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54980COMDInterventional Cardiology Physician
MD60829836WAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jul 9, 2018 Accepting new patients
The Vancouver Clinic Inc PS Cardiovascular Disease CurrentSince Jul 9, 2018 Accepting new patients

Locations

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

2525 NE 139th St
Ste 210
Vancouver, WA 98686

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

700 NE 87th Ave
Ste 210
Vancouver, WA 98664

Interoperability endpoints

  • Direct secure messaging: mryan12603@tvc-direct.org

Organizations & group practices 2

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1811151723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 PATTERSON RD",
            "address_2": "SUITE 605",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815061936",
            "telephone_number": "970-298-2482",
            "fax_number": "970-298-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98664",
            "telephone_number": "608-822-7783",
            "fax_number": "360-604-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "54980",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD60829836",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "54980",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD60829836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100218",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.