Jeffrey Ryan, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS20961 Issued in FL

Practice address

244 Saint Augustine Ave Apt 101
Venice, FL 34285-1839

Phone

(518) 852-3955

NPI assigned

Oct 25, 2006

Last updated

Jun 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family PracticeAlso: Psychiatry

Education

Other, 1994

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ibis Healthcare Inc

  dba Gracepoint

  • Community/Behavioral Health Agency
  • Tampa, FL
  • NPI 1346224011
  Medicare reassignment NPD
• Ibis Healthcare Inc

  dba Gracepoint

  • Federally Qualified Health Center (FQHC)
  • Tampa, FL
  • NPI 1922777218
  NPD
• Capital Imaging Associates

  • Diagnostic Radiology Physician
  • Cohoes, NY
  • NPI 1093794513
  NPD (past)
• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1881778637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9936 AZALEA BLOOM WAY APT 404",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784629",
            "telephone_number": "518-852-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 SAINT AUGUSTINE AVE APT 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342851839",
            "telephone_number": "518-852-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS20961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02243176",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oliva Russo, APRN
• Shelly Russo, APRN
• Kimberly Ann Ruzek, MD
• Ryan S. Holbrook, DMD, P.a. (Florida Dental Implant Center)
• Heather L. Ryan, MA, ATC, LAT
• Patricia Jo Ryan, PH.D.
• S N J Simply Fit
• S-H Thirty-Five Opco - Bella Vita, LLC
• Reinaldo Sabates, LICENSES DISPENSING
• Albina Sado

• Family Medicine Physician in Venice, FL
• Providers in Venice, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.