RYAN CORDERO MD
NPI 1417699166
Student in an Organized Health Care Education/Training Program in Queens Village, NY
About Ryan Cordero Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RYAN CORDERO MD (NPI 1417699166) is an individual student in an organized health care education/training program in Queens Village, New York and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
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
Ryan Cordero 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.
Medicare Billing Reassignment
Medicare enrollment records show Ryan Cordero reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Du Bois, PA 15801
- Reassigned Medicare billing, Pennsylvania enrollment
- 95 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Ryan Cordero's NPI number?
The NPI number for Ryan Cordero is 1417699166. It was assigned to this individual provider in the NPPES registry on April 12, 2022.
Where is Ryan Cordero located?
Ryan Cordero practices at 79-25 Winchester Blvd, Queens Village, Ny 11427, Queens Village, NY 11427. The listed phone number is (718) 264-5030.
What is Ryan Cordero's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Ryan Cordero enrolled in Medicare?
Yes. Ryan Cordero 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 organization bills Medicare for Ryan Cordero's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Cordero reassigns Medicare benefits to Clearfield-Jefferson Primary Care Associates PC (Du Bois, PA). 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 Ryan Cordero'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 Ryan Cordero was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days 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.
# Ryan Cordero, MD · NPI 1417699166
Student in an Organized Health Care Education/Training Program provider in Queens Village, New York. Individual provider, active in the CMS NPPES registry since April 12, 2022.
## Identity
- **NPI:** 1417699166 (Entity type: Individual)
- **Enumerated:** April 12, 2022
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 79-25 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427, Queens Village, NY 11427
- **Phone:** (718) 264-5030
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Clearfield-Jefferson Primary Care Associates PC (NPI 1710233895, Du Bois, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** September 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1417699166) · Data from the CMS NPPES public registry.