Jacqueline Ryan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0057078 Issued in MD

Practice address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Phone

(301) 790-8804

NPI assigned

Mar 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Internal MedicineAlso: Hospitalist

Education

Stanford University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alignmed Medical Group PCGroup PAC ID 3476090440, 62 clinicians

Alignmed Partners PCGroup PAC ID 9739447400, 34 clinicians

Adfinitas Health at Encompass Rehab LLCGroup PAC ID 6103283379, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023
• Luminis Health Doctors Community Medical Ctr, Inc Hospital, Lanham, MD, CCN 210051
• University of MD Capital Region Medical Center Hospital, Upper Marlboro, MD, CCN 210003
• Autumn Lake Healthcare at Waugh Chapel Nursing home, Gambrills, MD, CCN 215148
• Autumn Lake Healthcare at Spa Creek Nursing home, Annapolis, MD, CCN 215258
• Complete Care at Corsica Hills LLC Nursing home, Centreville, MD, CCN 215114

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• 1221 Waugh Chapel Opco LLC

  • Skilled Nursing Facility
  • Gambrills, MD
  • NPI 1912583683

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Adfinitas Health at Encompass Rehab LLC

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1568152932

  DC

  Medicare reassignment Care Compare group NPD
• Alignmed Medical Group, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1366289423

  DC

  Medicare reassignment Care Compare group NPD
• Alignmed Partners, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gardendale, AL
  • NPI 1881109452

  DC, MD

  Medicare reassignment Care Compare group NPD
• Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Salisbury, MD
  • NPI 1881635183
  Medicare reassignment NPD
• Luminis Health Medical Group, LLC

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment NPD
• Mdics at Anne Arundel LLC

  • Hospitalist Physician
  • Annapolis, MD
  • NPI 1427343664
  Medicare reassignment NPD
• Mdics Rehabilitative Services - Ltcaco LLC

  • Internal Medicine Physician
  • La Plata, MD
  • NPI 1033005475

  DC

  Medicare reassignment NPD
• Mdics Rehabilitative Services LLC

  • Internal Medicine Physician
  • Glen Burnie, MD
  • NPI 1124313309

  DC

  Medicare reassignment NPD
• Genesis Eldercare Physician Services LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1588690135

  DC

  Medicare reassignment NPD
• Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Towson, MD
  • NPI 1699280511
  NPD
• Luminis Health Medical Group, LLC

  • Surgery Physician
  • Annapolis, MD
  • NPI 1649248485
  NPD
• Luminis Health Medical Group, LLC

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• 1221 Waugh Chapel Opco LLC

  • Skilled Nursing Facility
  • Gambrills, MD
  • NPI 1912583683

  Nursing home

  Care Compare affiliation
• 35 Milkshake Opco LLC

  • Skilled Nursing Facility
  • Annapolis, MD
  • NPI 1194301861

  Nursing home

  Care Compare affiliation
• Complete Care at Corsica Hills LLC

  • Skilled Nursing Facility
  • Centreville, MD
  • NPI 1871173062

  Nursing home

  Care Compare affiliation
• Dimensions Health Corporation

  • General Acute Care Hospital
  • Upper Marlboro, MD
  • NPI 1720099286
  Care Compare affiliation
• Luminis Health Anne Arundel Medical Center, Inc.

  • Clinical Medical Laboratory
  • Annapolis, MD
  • NPI 1356885032

  Hospital

  Care Compare affiliation
• Luminis Health Anne Arundel Medical Center, Inc.

  • General Acute Care Hospital
  • Annapolis, MD
  • NPI 1477517225
  Care Compare affiliation
• Luminis Health Doctors Community Medical Center, Inc.

  • General Acute Care Hospital
  • Lanham, MD
  • NPI 1730136532
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1851360192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64916",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644916",
            "telephone_number": "443-481-6573",
            "fax_number": "444-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-790-8804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013280",
            "country_code": "US",
            "telephone_number": "443-481-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0057078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "0017",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7539450",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3112374",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "61003502",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110243912",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "827402900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Russo, CRNA
• David Forrest Rutherford, LCSWC MSSW
• Amber Rutkowski, CRNP
• Ryan Physical Therapy Associates
• Deborah Jean Ryan, PT, DPT
• Stephen Daniel Ryan, P.T.
• George P Saba II, M.D.
• Sarah Sabol, MS
• Stephen Mark Sachs, MD
• Safe Haven Counseling

• Internal Medicine Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.