Individual provider Active NPI

Ryan Riordan, PA-C

  • Physician Assistant
  • Batavia, IL
National Provider Identifier
1972149144
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
23.004803 Issued in CT
Practice address
23 S Jefferson St
Batavia, IL 60510-2419
Phone
(630) 341-2467
NPI assigned
Nov 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0006001 CO
Physician Assistant 363A00000X 23.004803 CT Primary
Physician Assistant 363A00000X 085007460 IL

Addresses

Primary practice location

23 S Jefferson St
Batavia, IL 60510-2419

Mailing address

550 W Ogden Ave
Hinsdale, IL 60521-3816
Phone (630) 323-6116

Other identifiers 1

IdentifierTypeStateIssuer
085007460OtherILPA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL email

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200605001927 CT Practitioner - Physician Assistant 0143641787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0006001COMDPhysician Assistant
23.004803CTMDPhysician Assistant
085007460ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince May 2, 2020 Accepting new patients
Yale University CurrentSince May 2, 2020 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: rriordan460116@direct.ynhh.org

Organizations & group practices 3

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": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1972149144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213816",
            "telephone_number": "630-323-6116",
            "fax_number": "630-794-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S JEFFERSON ST",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605102419",
            "telephone_number": "630-341-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIORDAN",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-22",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006001",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "23.004803",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007460",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "085007460",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "550 W Ogden Ave",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

Verify at the official NPI Registry.