RYAN DAVIDSON PA-C
NPI 1124803184
Physician Assistant in Chicago, IL

Q: What is Ryan Davidson's NPI number?

The NPI number for Ryan Davidson is 1124803184. It was assigned to this individual provider in the NPPES registry on August 29, 2023.

Q: What is Ryan Davidson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Ryan Davidson was last updated on January 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.

Active since August 29, 2023PECOS EnrolledAccepts Medicare Assignment

1611 W HARRISON ST STE 400, CHICAGO, IL 60612(877) 632-6637 Get Directions Write a Review

NPPES record last updated: January 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 3, 2025, Aug 29, 2023 (2 updates tracked since 2023).

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About Ryan Davidson Pa-c NPPES

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

RYAN DAVIDSON PA-C (NPI 1124803184) is an individual physician assistant in Chicago, Illinois, licensed in Illinois (085010868) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1124803184

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameRYAN DAVIDSONCredential: PA-C

Location Address1611 W HARRISON ST STE 400Chicago, IL 60612-4861

Mailing Address1611 W Harrison St Ste 400Chicago, IL 60612-4861

Phone(877) 632-6637

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 29, 2023

Last NPPES UpdateJanuary 3, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 3, 2025

✔ NPI 1124803184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in IL · 085010868✔ Licensed in IN · 10004693A

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1611 W HARRISON ST STE 400, Chicago, IL 60612

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ryan Davidson Pa-c 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 ID9335676295

PECOS Enrollment IDI20241217002936, I20250110001944

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60612 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. CHIZITAM IBEZIM MD

Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)