Individual provider Active NPI

Ryan Morgan, DO

  • Family Medicine Physician
  • Superior, WI
National Provider Identifier
1821518267
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71742-21 Issued in WI
Practice address
3500 Tower Ave
Superior, WI 54880-4491
Phone
(715) 817-7100
Fax
(715) 817-7039
NPI assigned
Jun 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT017738 PA
Family Medicine Physician 207Q00000X 71742-21 WI Primary

Addresses

Primary practice location

3500 Tower Ave
Superior, WI 54880-4491

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951

Other practice location 1

24 Doctors Ln Ste 202
Clarion, PA 16214-8574
Phone (814) 226-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20201228001090 WI Practitioner - Family Practice 9234542838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
BLDG C
Duluth, MN 55811-5640
Phone (218) 786-5360

3500 Tower Ave
Superior, WI 54880-4491
Phone (715) 392-8281

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT017738PAMDFamily Medicine Physician
71742-21WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Hospital of Superior Current Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Sep 10, 2020 Accepting new patients
St. Mary'S Duluth Clinic Health System Current Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 5

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.

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1821518267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548804491",
            "telephone_number": "715-817-7100",
            "fax_number": "715-817-7039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Doctors Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "162148574",
            "country_code": "US",
            "telephone_number": "814-226-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT017738",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "71742-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, WI

Sources for this page

Verify at the official NPI Registry.