Glen Ryan, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

T2058 Issued in TX

Practice address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Phone

(952) 595-1301

Fax

(612) 294-4903

NPI assigned

Jun 13, 2014

Last updated

Feb 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, CA, MI, MT, MN, IA6 enrollments

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 6

Specialty

Diagnostic Radiology

Education

Texas Tech University Health Science Center School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden State Imaging Associates IncGroup PAC ID 1254761315, 242 clinicians

Palm Desert Radiology Medical Group IncGroup PAC ID 0749173789, 125 clinicians

Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Radiologists Associated in Duluth LTDGroup PAC ID 4284547209, 45 clinicians

Renaissance Imaging Medical Associates IncGroup PAC ID 7315841756, 126 clinicians

Virtual Radiologic Professionals of Texas I, PAGroup PAC ID 6204838766, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599
• King's Daughters' Medical Center Hospital, Ashland, KY, CCN 180009
• Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235
• Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056
• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: casacolina@direct.casacolina.org

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.

• Radiologists Associated in Duluth LTD

  • Diagnostic Radiology Physician
  • Hibbing, MN
  • NPI 1598722688

  TX

  Medicare reassignment Care Compare group NPD
• Virtual Radiologic Professionals of Texas I, P.a.

  • Diagnostic Radiology Physician
  • Edina, MN
  • NPI 1184725228

  TX

  Medicare reassignment Care Compare group NPD
• Golden State Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1144872052
  Medicare reassignment Care Compare group NPD
• Palm Desert Radiology Medical Group, Inc

  dba Eisenhower Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1124079868

  TX

  Medicare reassignment Care Compare group NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406

  TX

  Medicare reassignment Care Compare group NPD
• Renaissance Imaging Medical Associates, Inc.

  • Diagnostic Radiology Physician
  • Northridge, CA
  • NPI 1487608931

  TX

  Medicare reassignment Care Compare group NPD
• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Medicare reassignment NPD
• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1295726362
  Medicare reassignment NPD
• Mille Lacs Health System

  dba Critical Access Hospital

  • Critical Access Hospital
  • Onamia, MN
  • NPI 1548212699
  Medicare reassignment NPD
• Angelina Diagnostic Radiology Associates

  dba ADRA Medical Imaging

  • Diagnostic Radiology Physician
  • Lufkin, TX
  • NPI 1033175302
  Medicare reassignment NPD
• Beacon Dowagiac, Inc

  • Critical Access Hospital
  • Dowagiac, MI
  • NPI 1194771030
  Medicare reassignment NPD
• Belmond Community Hospital

  dba Iowa Specialty Hospital- Belmond

  • Family Medicine Physician
  • Belmond, IA
  • NPI 1821122623

  TX

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  Care Compare affiliation
• Ashland Hospital Corporation

  dba Kings Daughters Medical Center

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation
• Providence Health System - Southern California

  dba Providence Saint Joseph Medical Center

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  Care Compare affiliation
• Regents of the University of California

  dba University of California Davis Medical Center

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1710918545
  Care Compare affiliation

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1932513306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39000 Bob Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922703221",
            "country_code": "US",
            "telephone_number": "760-340-3911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "GLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-13",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "T2058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David G Rustad, MD
• Jill Harriet Rusterholz, M.D.
• Lisa Marie Rutford, MA, LPCC
• RX Angels LLC
• Barb Ryan, L.M.T.
• Waleed Saadedeen, MD
• Benjamin Saaribovre, DC
• Lauren Kensey Sabrowsky, PT
• Robyn Marie Sacia, PHARM.D.
• Sahra Sadiiq

• Diagnostic Radiology Physician in Edina, MN
• Providers in Edina, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.