Active NPI
Dianne Ryan
- Specialist
- Jefferson Valley, NY
National Provider Identifier
1811529902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 019598-1
- Practice address
- 3630 Hill Blvd Ste 401
Jefferson Valley, NY 10535-1506 - Phone
- (845) 661-2742
- NPI assigned
- Feb 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 019598-1 | NY | Primary |
Addresses
Primary practice location
3630 Hill Blvd Ste 401
Jefferson Valley, NY 10535-1506
Mailing address
69 Highland View Rd
Mahopac, NY 10541-3111
Phone (845) 661-2742
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | laptop |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019598-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1811529902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 HIGHLAND VIEW RD",
"city": "MAHOPAC",
"state": "NY",
"postal_code": "105413111",
"telephone_number": "845-661-2742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3630 HILL BLVD STE 401",
"city": "JEFFERSON VALLEY",
"state": "NY",
"postal_code": "105351506",
"telephone_number": "845-661-2742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "DIANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-07",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "NY",
"license": "019598-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "laptop",
"affiliation": "N",
"address_1": "3630 Hill Blvd Ste 101",
"city": "Jefferson Valley",
"state": "NY",
"country_code": "US",
"postal_code": "105351503",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jefferson Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.