NPIMap

Individual provider Active NPI

Sean D Ryan, PA-C

  • Medical Physician Assistant
  • Lehigh Acres, FL
National Provider Identifier
1992789655
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2751 Issued in FL
Practice address
1500 Lee Blvd
Lehigh Regional Medical Center
Lehigh Acres, FL 33936-4835
Phone
(239) 369-2101
Fax
(239) 368-4510
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA2751 FL Primary

Addresses

Primary practice location

1500 Lee Blvd
Lehigh Regional Medical Center
Lehigh Acres, FL 33936-4835

Mailing address

1500 Lee Blvd
Lehigh Regional Medical Center
Lehigh Acres, FL 33936-4835
Phone (239) 369-2101

Other identifiers 1

IdentifierTypeStateIssuer
290503500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leeland ER SVCS Partnership LLC Past Accepting new patients
Naples Emergency Physicians LLC Past Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
Gulf Coast Emergency Physicians PA Past Accepting new patients

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1992789655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LEE BLVD",
            "address_2": "LEHIGH REGIONAL MEDICAL CENTER",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364835",
            "telephone_number": "239-369-2101",
            "fax_number": "239-368-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LEE BLVD",
            "address_2": "LEHIGH REGIONAL MEDICAL CENTER",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364835",
            "telephone_number": "239-369-2101",
            "fax_number": "239-368-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SEAN",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290503500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.