Individual provider Active NPI

Ryan O'Kelley, D.O.

  • Diagnostic Radiology Physician
  • Panama City, FL
National Provider Identifier
1871887489
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS20263 Issued in FL
Practice address
615 N Bonita Ave
Panama City, FL 32401-3623
Phone
(850) 769-1511
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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 OS20263 FL Primary

Addresses

Primary practice location

615 N Bonita Ave
Panama City, FL 32401-3623

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other identifiers 1

IdentifierTypeStateIssuer
003214254AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170627001058 TN Practitioner - Diagnostic Radiology 5395048276
I20190205003437 GA Practitioner - Interventional Radiology 5395048276
I20240830000213 FL Practitioner - Interventional Radiology 5395048276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

5151 N 9TH Ave
Suite 200
Pensacola, FL 32504-8721
Phone (850) 416-4188

Hospital & facility affiliations

  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026

Merit-based Incentive Payment System (MIPS)

Final score
83.11 of 100Reported as group
Quality
51.32
Promoting interoperability
98
Improvement activities
40
Cost
79.36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Savannah Vascular Institute, LLC Vascular & Interventional Radiology CurrentSince Jan 1, 2019 Accepting new patients
Sacred Heart Health System Inc CurrentSince Aug 26, 2024 Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

5151 N 9th Ave
Ste 200
Pensacola, FL 32504
Phone (850) 416-4188

4750 Waters Ave
Ste 500
Savannah, GA 31404
Phone (912) 350-5961

Interoperability endpoints

  • Direct secure messaging: ryan.okelley.p2@direct.savannahvascular.nextgenshare.com
  • Direct secure messaging: ryan.okelley.p1@direct.savannahvascular.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1871887489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623",
            "telephone_number": "850-769-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KELLEY",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS20263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003214254A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.