SHANTI RYAN PA-C
NPI 1629884325
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since December 06, 2024PECOS EnrolledAccepts Medicare Assignment
3822 SE POWELL BLVD, PORTLAND, OR 97202(888) 227-3312(503) 717-9966 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 4, 2025, Dec 6, 2024 (2 updates tracked since 2024).

About Shanti Ryan Pa-c NPPES

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

SHANTI RYAN PA-C (NPI 1629884325) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS, is affiliated with Providence Portland Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1629884325
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHANTI RYANCredential: PA-C
Location Address3822 SE POWELL BLVDPortland, OR 97202-1720
Mailing Address3915 E Camelback RdPhoenix, AZ 85018-2633 · (928) 533-8513
Fax(503) 717-9966
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateDecember 6, 2024
Last NPPES UpdateNovember 4, 20252 updates tracked since enumeration
NPPES CertifiedNovember 4, 2025
NPI 1629884325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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.
Also ListedPhysician AssistantTaxonomy 363A00000X
3822 SE POWELL BLVD, Portland, OR 97202

Other Identifiers 2

Other1234509WA · Certification
OtherPA70046563WA · License

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

Shanti Ryan 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 ID7618468596
PECOS Enrollment IDI20251118005074
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.

Hospital Affiliations CMS Care Compare

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

Providence Portland Medical Center

Acute Care Hospitals · Portland, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380061
Location4805 NE Glisan StreetPortland, OR 97213 · Multnomah County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 2

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

Physician Assistant
3822 SE POWELL BLVD
PORTLAND, OR 97202
Pharmacy (Community/Retail Pharmacy)
3822 SE POWELL BLVD
PORTLAND, OR 97202

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 Shanti Ryan's NPI number?

The NPI number for Shanti Ryan is 1629884325. It was assigned to this individual provider in the NPPES registry on December 6, 2024.

Where is Shanti Ryan located?

Shanti Ryan practices at 3822 SE Powell Blvd, Portland, OR 97202. The listed phone number is (888) 227-3312.

What is Shanti 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 Shanti Ryan enrolled in Medicare?

Yes. Shanti 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.

Is Shanti Ryan affiliated with any hospitals?

According to CMS data, Shanti Ryan is affiliated with Providence Portland Medical Center.

When was this NPI record last updated?

The NPPES record for Shanti Ryan was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.