Individual provider Active NPI

Ryan Dale Freeland, MD

  • Dermatology Physician
  • Wyoming, MI
National Provider Identifier
1942265178
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301084275 Issued in MI
Practice address
1673 Gezon Pkwy SW
Wyoming, MI 49519
Phone
(616) 893-6324
Fax
(616) 243-3377
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101258010 VA
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 4301084275 MI Primary

Addresses

Primary practice location

1673 Gezon Pkwy SW
Wyoming, MI 49519

Mailing address

1673 Gezon Pkwy SW
Wyoming, MI 49519-9519
Phone (616) 893-6324

Other identifiers 1

IdentifierTypeStateIssuer
4301084275OtherMISTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171130002546 MI Practitioner - Dermatology 3971860842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Loyola University of Chicago, Stritch School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wolverine Dermatology PCGroup PAC ID 9638435191, 4 clinicians

Practice addresses (Care Compare)

1673 Gezon Pkwy SW
Wyoming, MI 49519-9519
Phone (616) 243-3376

Hospital & facility affiliations

  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Merit-based Incentive Payment System (MIPS)

Final score
88.55 of 100Reported as group
Quality
77.1
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision15
Removal of skin lesions434
Removal or shaving of skin growth15
Skin biopsy91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101258010VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wolverine Dermatology, PC Multi-Specialty CurrentSince Jan 1, 2018 Accepting new patients

Locations

1673 Gezon Pkwy SW
Wyoming, MI 49519
Phone (616) 243-3376

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00325

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1942265178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 GEZON PKWY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199519",
            "telephone_number": "616-893-6324",
            "fax_number": "616-243-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 GEZON PKWY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-893-6324",
            "fax_number": "616-243-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREELAND",
        "first_name": "RYAN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101258010",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301084275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "4301084275",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.