NPIMap

Individual provider Active NPI

Ryan J Minnich, DO

  • Family Medicine Physician
  • Saint Marys, PA
National Provider Identifier
1881653053
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS014502 Issued in PA
Practice address
1100 Million Dollar Hwy
Saint Marys, PA 15857-2728
Phone
(814) 781-6758
Fax
(814) 781-3317
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 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 02003013A IN
Family Medicine Physician 207Q00000X OS014502 PA Primary

Addresses

Primary practice location

1100 Million Dollar Hwy
Saint Marys, PA 15857-2728

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-4024

Other practice location 1

761 Johnsonburg Rd Ste 160
Saint Marys, PA 15857-3484
Phone (814) 788-8777

Other identifiers 2

IdentifierTypeStateIssuer
102196789MedicaidPA
200800460MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081007000347 PA Practitioner - Family Practice 9537068358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
St Joseph Medical GroupGroup PAC ID 3779688650, 190 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

805 N Richmond St
Fleetwood, PA 19522-1058
Phone (610) 944-0464

Hospital & facility affiliations

  • Patient Care Home health agency, Wyomissing, PA, CCN 397578
  • Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096
  • Reading Hospital Hospital, West Reading, PA, CCN 390044
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

Merit-based Incentive Payment System (MIPS)

Final score
79.31 of 100Reported as group
Quality
55.01
Promoting interoperability
99
Improvement activities
40
Cost
76.86

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1698WVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Medical Group CurrentSince Dec 3, 2023 Accepting new patients
St. Joseph Medical Group Family Medicine CurrentSince Dec 3, 2023 Accepting new patients
Integrated Medical Group, P.C. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

805 N Richmond St
Fleetwood, PA 19522
Phone (610) 944-0464

805 N Richmond St
Ste 101
Fleetwood, PA 19522
Phone (610) 944-0464

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

4301 5th Street Hwy
Ste 101
Temple, PA 19560
Phone (610) 208-8800

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1881653053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-4024",
            "fax_number": "814-372-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MILLION DOLLAR HWY",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158572728",
            "telephone_number": "814-781-6758",
            "fax_number": "814-781-3317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "761 Johnsonburg Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Saint Marys",
            "state": "PA",
            "postal_code": "158573484",
            "country_code": "US",
            "telephone_number": "814-788-8777",
            "fax_number": "814-788-8770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINNICH",
        "first_name": "RYAN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003013A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102196789",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200800460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, PA

Sources for this page

Verify at the official NPI Registry.