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CASEY AILEEN RYAN MD
NPI 1265173744
Student in an Organized Health Care Education/Training Program in Tampa, FL

Active since April 06, 2022PECOS Enrolled
17 DAVIS BLVD STE 308, TAMPA, FL 33606(813) 974-2201 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Casey Aileen Ryan Md NPPES

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

CASEY AILEEN RYAN MD (NPI 1265173744) is an individual student in an organized health care education/training program in Tampa, Florida and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Pennsylvania State University College Of Medicine (2022).

NPPES Registry Identity

NPI1265173744
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameCASEY AILEEN RYANCredential: MD
Location Address17 DAVIS BLVD STE 308Tampa, FL 33606-3438
Mailing Address17 Davis Blvd Ste 308Tampa, FL 33606-3438
Phone(813) 974-2201
Sole ProprietorNo
Medical School CMSPennsylvania State University College Of MedicineGraduated 2022
Enumeration DateApril 6, 2022
NPPES CertifiedApril 6, 2022
✔ NPI 1265173744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
17 DAVIS BLVD STE 308, Tampa, FL 33606
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Casey Aileen Ryan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4385114297
PECOS Enrollment IDI20260601001938
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 Reassignment

Medicare enrollment records show Casey Ryan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Saint Johns Medical Foundation
2,167 mi
Specialist
2121 SANTA MONICA BLVD
Santa Monica, CA 90404
  • Reassigned Medicare billing, California enrollment
  • 461 clinicians in this Medicare group
NPI 1770093734 (310) 582-7312

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

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.

MARISOL GOMEZ MD
Student in an Organized Health Care Education/Training Program
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (727) 462-7000
DR. SARA KHAN MD
Student in an Organized Health Care Education/Training Program
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (813) 974-2202
PETER BRANDON DOMINGUEZ MD
Emergency Medicine
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (813) 844-7000
NICHOLAS BRENNAN WAGNER MD
Student in an Organized Health Care Education/Training Program
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (813) 974-2201
JACOB ALEXANDER KALIN DO
Student in an Organized Health Care Education/Training Program
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (813) 844-7000
MICHAEL BRANDON CISNEROS MD
Student in an Organized Health Care Education/Training Program
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (813) 974-2201
DR. SANTIAGO BEJARANO HERNANDEZ MD, MPH
Student in an Organized Health Care Education/Training Program
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (813) 844-7000
LIDIA ODALIS LOPEZ
Student in an Organized Health Care Education/Training Program
17 DAVIS BLVD STE 308
TAMPA, FL 33606
Hillsborough County (813) 974-2201

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 Casey Ryan's NPI number?

The NPI number for Casey Ryan is 1265173744. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Casey Ryan located?

Casey Ryan practices at 17 Davis Blvd Ste 308, Tampa, FL 33606. The listed phone number is (813) 974-2201.

What is Casey Ryan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Casey Ryan enrolled in Medicare?

Yes. Casey Ryan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Casey Ryan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Casey Ryan reassigns Medicare benefits to Providence Saint Johns Medical Foundation (Santa Monica, CA). The 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 Casey Ryan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Casey Ryan was last updated on April 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.