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DR. PHILIP J A RYAN MD
NPI 1043396229
Internal Medicine - Endocrinology, Diabetes & Metabolism in Martinsburg, WV

Active since October 31, 2006PECOS EnrolledAccepts Medicare Assignment
176 HEALTH CARE LN, SUITE B, MARTINSBURG, WV 25401(304) 260-1060(304) 260-1062 Get Directions Write a Review

NPPES record last updated: February 7, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Philip J A Ryan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PHILIP J A RYAN MD (NPI 1043396229) is an individual endocrinology, diabetes & metabolism provider in Martinsburg, West Virginia, licensed in West Virginia (01126) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Berkeley Medical Center, and is a graduate of Indiana University School Of Medicine (1976).

NPPES Registry Identity

NPI1043396229
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameDR. PHILIP J A RYANCredential: MD
Location Address176 HEALTH CARE LN, SUITE BMartinsburg, WV 25401-4010
Mailing Address176 Health Care Ln, Suite BMartinsburg, WV 25401-4010 · (304) 260-1060 · Fax (304) 260-1062
Phone(304) 260-1060
Fax(304) 260-1062
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1976
Enumeration DateOctober 31, 2006
Last NPPES UpdateFebruary 7, 2012
✔ NPI 1043396229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in WV · 01126
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
176 HEALTH CARE LN, Martinsburg, WV 25401
Open in Google Maps ↗

Other Identifiers 5

Other0001714408WV · Blue Cross Blue Shield
Medicaid2006615000WV
Medicare UPINE03821
Medicare PINWV0833A548WV
Medicare PIN4122311WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Philip J A Ryan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264325471
PECOS Enrollment IDI20040203000410
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Philip Ryan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Diabetes, Endocrinology & Lipidology Center, Inc.
Same address
Endocrinology, Diabetes & Metabolism
176 HEALTH CARE LN, SUITE B
Martinsburg, WV 25401
  • Reassigned Medicare billing, West Virginia enrollment
NPI 1275810830 (304) 260-1060
Medical Office Force
485 mi
Internal Medicine
2005 PRINCE AVENUE
Athens, GA 30606
  • Reassigned Medicare billing, West Virginia enrollment
NPI 1508378613 (706) 208-9700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
435 services165 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
339 services126 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
313 services123 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
33 services33 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
29 services29 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
18 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
64%1,339 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
90%747 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
97%703 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%703 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
95%703 patients5/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
6 suppliers21 claims266 services$17.72 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
5 suppliers19 claims570 services$2.37 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
27 suppliers76 claims305 services$5.83 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers24 claims37 services$1.15 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
9 suppliers109 claims109 services$183.98 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALI REZAIAN
Chiropractor
176 HEALTH CARE LN
MARTINSBURG, WV 25401
Berkeley County (681) 389-2059
DIABETES, ENDOCRINOLOGY & LIPIDOLOGY CENTER, INC.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
176 HEALTH CARE LN, SUITE B
MARTINSBURG, WV 25401
Berkeley County (304) 260-1060
ARASH HASSANTOUFIGHI MD
Internal Medicine (Rheumatology)
176 HEALTH CARE LN
MARTINSBURG, WV 25401
Berkeley County (301) 996-7311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Philip Ryan's NPI number?

The NPI number for Philip Ryan is 1043396229. It was assigned to this individual provider in the NPPES registry on October 31, 2006.

Where is Philip Ryan located?

Philip Ryan practices at 176 Health Care Ln Suite B, Martinsburg, WV 25401. The listed phone number is (304) 260-1060.

What is Philip Ryan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Philip Ryan enrolled in Medicare?

Yes. Philip Ryan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Philip Ryan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Philip Ryan reassigns Medicare benefits to 2 organizations: Diabetes, Endocrinology & Lipidology Center, Inc. (Martinsburg, WV) and Medical Office Force (Athens, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Philip Ryan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Philip Ryan accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Philip Ryan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Philip Ryan affiliated with any hospitals?

According to CMS data, Philip Ryan is affiliated with Berkeley Medical Center.

When was this NPI record last updated?

The NPPES record for Philip Ryan was last updated on February 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.