Individual provider Active NPI

Ryan Matthew Hom, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1912566209
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA56865 Issued in CA
Practice address
814 Francisco St
Los Angeles, CA 90017-2530
Phone
(310) 491-7070
NPI assigned
Jun 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA56865 CA Primary

Addresses

Primary practice location

814 Francisco St
Los Angeles, CA 90017-2530

Mailing address

PO Box 11013
Burbank, CA 91510-1013
Phone (818) 669-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829003664 CA Practitioner - Physician Assistant 4183952021 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

25548 The Old Rd
Suite U1
Stevenson Ranch, CA 91381-1705
Phone (661) 556-9020

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

475 Foothill Blvd
Suite K
La Canada, CA 91011-3555
Phone (818) 528-6377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56865CAMDPharmacist
PA56865CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Feb 11, 2020 Accepting new patients
Providence Facey Medical Foundation CurrentSince Feb 11, 2020 Accepting new patients

Locations

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

235 E 17th St
Costa Mesa, CA 92627
Phone (949) 688-2010

475 Foothill Blvd
Ste K
La Canada, CA 91011
Phone (818) 528-6377

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

14550 Soledad Canyon Rd
#100
Santa Clarita, CA 91387
Phone (661) 488-7402

25548 The Old Rd
Ste U1
Stevenson Ranch, CA 91381
Phone (661) 556-9020

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

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.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1912566209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11013",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915101013",
            "telephone_number": "818-669-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 FRANCISCO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900172530",
            "telephone_number": "310-491-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOM",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.