Individual provider Active NPI

Ryan Jeffrey Caldwell

  • Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1821663857
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704302102 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 593-7000
NPI assigned
May 21, 2021
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704302102 MI Primary
Acute Care Nurse Practitioner 363LA2100X 4704302102 MI
Registered Nurse 163W00000X 4704302102 MI

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1848

Other practice location 1

5450 Fort St
Trenton, MI 48183-4601
Phone (734) 671-3800

Other practice location 2

5450 Fort St Ste 100
Trenton, MI 48183-4601
Phone (734) 642-2482

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rcaldwell1912874@direct.beaumont.edu
Direct Messaging Address rcaldwell1912874@direct.beaumont.edu
Direct Messaging Address rcaldwell1912874@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211109000914 MI Practitioner - Nurse Practitioner 4789073958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Olma Specialty 1 LLC CurrentSince Jun 1, 2025 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Oct 3, 2021 Accepting new patients
Iha Olma Specialty 1 LLC CurrentSince Jun 1, 2025 Accepting new patients
Iha Olma Specialty 1 LLC Current Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

5450 Fort St
Ste 100
Trenton, MI 48183
Phone (734) 642-2363

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

5450 Fort St
Woodhaven, MI 48183
Phone (734) 671-3297

Interoperability endpoints

  • Direct secure messaging: rcaldwell1227715@epic00.shdirect.org
  • Direct secure messaging: rcaldwell1912874@direct.beaumont.edu
  • Direct secure messaging: rcaldwell3405293@direct.trinity-health.org

Organizations & group practices 4

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1821663857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1848",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5450 Fort St",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "MI",
            "postal_code": "481834601",
            "country_code": "US",
            "telephone_number": "734-671-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5450 Fort St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "MI",
            "postal_code": "481834601",
            "country_code": "US",
            "telephone_number": "734-642-2482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "RYAN",
        "middle_name": "JEFFREY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704302102",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704302102",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704302102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcaldwell1912874@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "5450 Fort St",
            "city": "Trenton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481834601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcaldwell1912874@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcaldwell1912874@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "5450 Fort St Ste 100",
            "city": "Trenton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481834601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.