Charles Joseph Ryan III, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

176888-1 Issued in NY

Practice address

3077 E Lake Rd
Skaneateles, NY 13152-9024

Phone

(315) 685-3966

Fax

(315) 685-5833

NPI assigned

Mar 2, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• David P Locastro, MD, PC

  • Surgery Physician
  • Skaneateles, NY
  • NPI 1023296845
  NPD (past)

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

{
    "created_epoch": "1362182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362182400000",
    "number": "1891036778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 E LAKE RD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131529024",
            "telephone_number": "315-685-3966",
            "fax_number": "315-685-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 E LAKE RD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131529024",
            "telephone_number": "315-685-3966",
            "fax_number": "315-685-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-02",
        "last_updated": "2013-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "176888-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "176888-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Marie Rabbia, CCC-SLP
• Jordan Christopher Reynolds, PA-C
• Peggy W Richards, MA EDUCATION
• Amanda Courtney Rose, PSYD
• Linda R. Rossi, EDD, MS, APRN, BC
• Saint Andrews Neuroscience(Medical Neuropsychiatry)LLC
• Debra L Sandbrook
• Trudy Raveaux Scarr, R.N.
• David Lee Schultz, MS, ATC
• Gary J Schwartz, LMHC BCN

• Vascular Surgery Physician in Skaneateles, NY
• Providers in Skaneateles, NY by specialty
• Vascular Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.