Individual provider Active NPI

Joseph P Ryan, MD

  • Pediatrics Physician
  • Greeley, CO
National Provider Identifier
1942288675
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33117 Issued in CO
Practice address
5881 W 16TH St
Greeley, CO 80634-2910
Phone
(970) 313-2700
Fax
(970) 313-2727
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33117 CO Primary

Addresses

Primary practice location

5881 W 16TH St
Greeley, CO 80634-2910

Mailing address

5881 W 16TH St
Greeley, CO 80634-2910
Phone (970) 313-2700

Other identifiers 2

IdentifierTypeStateIssuer
01331172MedicaidCO
P00944894OtherCOMEDICARE RAILROAD CARRIER PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20091230000170 CO Practitioner - Pediatric Medicine 5698815488 Reassigns benefits to 1 organization
I20180618002686 WY Practitioner - Pediatric Medicine 5698815488 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33117COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 13, 2010 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Ivinson Memorial Hospital CurrentSince May 8, 2018 Accepting new patients
Ivinson Memorial Hospital CurrentSince May 8, 2018 Accepting new patients
Uchealth Greeley Hospital Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 3
Greeley, CO 80634
Phone (970) 652-2801

5881 W 16th St
Greeley, CO 80634
Phone (970) 313-2700

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

5881 W 16th St
Ste B
Greeley, CO 80634
Phone (970) 336-1500

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

3520 E 15th St
Loveland, CO 80538
Phone (970) 313-2700

3520 E 15th St
Ste 201
Loveland, CO 80538
Phone (970) 203-7165

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

Organizations & group practices 5

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1942288675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2700",
            "fax_number": "970-313-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2700",
            "fax_number": "970-313-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "33117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01331172",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944894",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.