Individual provider Active NPI

Michael J Ryan, M.D.

  • Gastroenterology Physician
  • Norfolk, VA
National Provider Identifier
1962488668
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101036589 Issued in VA
Practice address
885 Kempsville Rd
Suite 114
Norfolk, VA 23502-3800
Phone
(757) 466-0165
Fax
(757) 466-7296
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101036589 VA Primary

Addresses

Primary practice location

885 Kempsville Rd
Suite 114
Norfolk, VA 23502-3800

Mailing address

885 Kempsville Rd
Suite 114
Norfolk, VA 23502-3800
Phone (757) 466-0165

Other identifiers 7

IdentifierTypeStateIssuer
1659563799OtherVAGROUP NPI
541870984-008OtherVACIGNA
8906542MedicaidNC
4004834OtherVAAETNA
15124OtherVAOPTIMA
5807751MedicaidVA
323627OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040102000056 VA Practitioner - Gastroenterology 7517866247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Johns Hopkins University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capital Digestive Care LLCGroup PAC ID 3870669419, 241 clinicians

Practice addresses (Care Compare)

885 Kempsville Rd
Suite 114
Norfolk, VA 23502-3800
Phone (757) 466-0165

Hospital & facility affiliations

  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy240
Upper gastrointestinal (GI) endoscopy for acid reflux233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101036589VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Digestive Care, LLC Gastroenterology CurrentSince Nov 26, 2021 Accepting new patients
Gastrointestinal and Liver Specialists of Tidewater, PLLC Current Accepting new patients
Capital Digestive Care ,LLC Gastroenterology CurrentSince Nov 26, 2021 Accepting new patients
Capital Digestive Care ,LLC Gastroenterology Current Accepting new patients

Locations

113 Gainsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 436-3285

885 Kempsville Rd
Ste 114
Norfolk, VA 23502
Phone (757) 466-0165

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.

Hospital & facility affiliations 6

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1962488668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 KEMPSVILLE RD",
            "address_2": "SUITE 114",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023800",
            "telephone_number": "757-466-0165",
            "fax_number": "757-466-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 KEMPSVILLE RD",
            "address_2": "SUITE 114",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023800",
            "telephone_number": "757-466-0165",
            "fax_number": "757-466-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101036589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1659563799",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "541870984-008",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8906542",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4004834",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "15124",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5807751",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "323627",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.