Individual provider Active NPI

Randall Ryan, MD

  • Diagnostic Radiology Physician
  • Newark, DE
National Provider Identifier
1811957970
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
C1-0003089 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Department of Radiology
Newark, DE 19718-2200
Phone
(302) 733-1806
Fax
(302) 733-1808
NPI assigned
Mar 24, 2006
Last updated
Apr 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X C1-0003089 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Department of Radiology
Newark, DE 19718-2200

Mailing address

4755 Ogletown Stanton Rd
Department of Radiology
Newark, DE 19718-2200
Phone (302) 733-1806

Other identifiers 2

IdentifierTypeStateIssuer
300074195OtherRAILROAD MEDICARE #
0000111701MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20060111000781 DE Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7618990060 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Jefferson Medical College of Thomas Jefferson University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

1401 Foulk Rd
Wilmington, DE 19803-2764

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Diagnostic Radiology CurrentSince Jun 1, 2013 Accepting new patients
Christiana Care Health Services Inc Diagnostic Radiology CurrentSince Dec 1, 2008 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Dec 1, 2008 Accepting new patients
Christiana Care Health Services Inc Diagnostic Radiology CurrentSince Dec 31, 2012 Accepting new patients
Christiana Care Health Services Inc Diagnostic Radiology CurrentSince Jan 1, 2013 Accepting new patients
Christiana Care Health Initiatives Past Accepting new patients
Christiana Care Health Initiatives Diagnostic Radiology Past Accepting new patients
X-Ray Associates P.a. Past Accepting new patients
X-Ray Associates, LLC Past Accepting new patients

Locations

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

Organizations & group practices 10

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1811957970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1806",
            "fax_number": "302-733-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1806",
            "fax_number": "302-733-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DE",
            "license": "C1-0003089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "300074195",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000111701",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.