Individual provider Active NPI

Ryan Paul Taylor

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1952902058
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60550 Issued in CA
Practice address
1630 E Herndon Ave
Fresno, CA 93720-3391
Phone
(559) 256-5200
NPI assigned
Nov 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 60550 CA Primary

Addresses

Primary practice location

1630 E Herndon Ave
Fresno, CA 93720-3391

Mailing address

2623 Yorba Linda Blvd Apt 222
Fullerton, CA 92831-1613
Phone (619) 370-0042

Other names 1

  • Mr. Ryan P Taylor Professional name

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
I20220728000208 CA Practitioner - Physician Assistant 8729460464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Girard Orthopaedic Surgeons Medical Group IncGroup PAC ID 6709773773, 8 clinicians

Practice addresses (Care Compare)

8851 Ctr Dr
Suite 601
La Mesa, CA 91942-3062
Phone (619) 441-9811

9333 Genesee Ave
Suite 350
San Diego, CA 92121-2103
Phone (858) 455-6460

Hospital & facility affiliations

National Provider Directory

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1952902058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 YORBA LINDA BLVD APT 222",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311613",
            "telephone_number": "619-370-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203391",
            "telephone_number": "559-256-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "RYAN",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-04",
        "last_updated": "2022-08-02",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "TAYLOR",
            "middle_name": "P",
            "prefix": "MR.",
            "credential": "PA-S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.