Active NPI
Pamela Ryder, NP
- Family Nurse Practitioner
- Jefferson, NY
National Provider Identifier
1891857199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 330006
- Practice address
- 765 Streeter Hill Rd
Jefferson, NY 12093 - Phone
- (646) 498-3049
- NPI assigned
- Dec 14, 2006
- Last updated
- Jul 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 330006 | NY | Primary |
Addresses
Primary practice location
765 Streeter Hill Rd
Jefferson, NY 12093
Mailing address
PO Box 460
Midland Park, NJ 07432-0460
Phone (646) 498-3049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1891857199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 460",
"city": "MIDLAND PARK",
"state": "NJ",
"postal_code": "074320460",
"telephone_number": "646-498-3049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "765 STREETER HILL RD",
"city": "JEFFERSON",
"state": "NY",
"postal_code": "12093",
"telephone_number": "646-498-3049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYDER",
"first_name": "PAMELA",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "330006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.