Philip Ryder, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

002240 Issued in NY

Practice address

596 Center Briarwood Ave
West Islip, NY 11795-4004

Phone

(191) 449-7291

NPI assigned

Jul 19, 2022

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1902531593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 CENTER BRIARWOOD AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954004",
            "telephone_number": "191-449-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 CENTER BRIARWOOD AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954004",
            "telephone_number": "191-449-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "PHILIP",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER",
            "identifier": "2000002396",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER",
            "identifier": "2000002396",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "philip.ryder@liu.edu",
            "affiliation": "N",
            "address_1": "596 Center Briarwood Ave",
            "city": "West Islip",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117954004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gail Remsem Ryan, RD CDN
• Joshua Everette Ryan, MD
• Laura Jayne Ryan
• Patrick J Ryan
• Michael T. Ryczek, D.D.S.
• Adriana Josephine Saab, PT,DPT
• Michael Sabatino, D.O.
• Satnam Kaur Sabharwal, M.D.
• Roxana Teodora Sacarin, MD
• Michael Joseph Sacca, MD

• Athletic Trainer in West Islip, NY
• Providers in West Islip, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.