Individual provider Active NPI

Michael J Ryan, M.D.

  • General Practice Physician
  • Boise, ID
National Provider Identifier
1821039025
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
M5502 Issued in ID
Practice address
232 S Whisperwood Way
Boise, ID 83709-4900
Phone
(208) 350-6450
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M5502 ID
General Practice Physician 208D00000X M5502 ID Primary

Addresses

Primary practice location

232 S Whisperwood Way
Boise, ID 83709-4900

Mailing address

PO Box 9649
Boise, ID 83707-4649
Phone (208) 472-8100

Other identifiers 1

IdentifierTypeStateIssuer
003908900MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200821002384 AZ Practitioner - Diagnostic Radiology 2567492838 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Physician Specialists LLCGroup PAC ID 5991008054, 343 clinicians
Banner - University Hospital Based Physicians LLCGroup PAC ID 1052614294, 343 clinicians

Practice addresses (Care Compare)

755 E McDowell Rd
Phoenix, AZ 85006-2506
Phone (602) 521-3086

807 S Ponderosa St
Payson, AZ 85541-5542
Phone (928) 471-3222

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093
  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
  • Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5502IDMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Dec 1, 2020 Accepting new patients
Banner Imaging Services LLC CurrentSince Jun 21, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Sep 28, 2020 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Sep 28, 2020 Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology Current Accepting new patients
Banner-University Medical Group Diagnostic Radiology CurrentSince Sep 28, 2020 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Dec 1, 2020 Accepting new patients
Banner - University Hospital Based Physicians LLC Current Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Sep 28, 2020 Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology CurrentSince Jun 21, 2024 Accepting new patients
Gooding County Hospital District Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Gem State Radiology LLP Diagnostic Radiology Past Accepting new patients

Locations

1828 E Florence Blvd
Ste 118
Casa Grande, AZ 85122
Phone (520) 381-9729

5601 W Eugie Ave
Ste 102
Glendale, AZ 85304
Phone (602) 588-3420

1800 N Civic Sq
Ste 120
Goodyear, AZ 85395
Phone (928) 813-4624

6553 E Baywood Ave
Ste 102
Mesa, AZ 85206
Phone (480) 268-7600

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

9305 W Thomas Rd
Ste 100
Phoenix, AZ 85037
Phone (623) 842-5652

4200 E Camelback Rd
Ste 105
Phoenix, AZ 85018

2222 E Highland Ave
Ste 106
Phoenix, AZ 85016
Phone (602) 483-6165

13909 W Camino del Sol
Ste 101
Sun City West, AZ 85375
Phone (623) 544-7300

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1821039025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9649",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837074649",
            "telephone_number": "208-472-8100",
            "fax_number": "208-344-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S WHISPERWOOD WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837094900",
            "telephone_number": "208-350-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M5502",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "M5502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003908900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.