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RYAN S. DIEDERICH, MD PC
NPI 1639817182
Surgery - Plastic and Reconstructive Surgery in Glen Carbon, IL

Active since May 24, 2022
4955 S STATE ROUTE 159 # 1, GLEN CARBON, IL 62034(618) 288-7855(618) 288-7866 Get Directions Write a Review

NPPES record last updated: May 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ryan S. Diederich, Md Pc NPPES

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

RYAN S. DIEDERICH, MD PC (NPI 1639817182), doing business as Midamerica Plastic Surgery, is a healthcare organization registered as a plastic and reconstructive surgery in Glen Carbon, Illinois and active in the NPI registry since May 2022. The organization lists Ryan S Diederich, Owner, as its authorized official.

NPPES Registry Identity

NPI1639817182
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameRYAN S. DIEDERICH, MD PC
Location Address4955 S STATE ROUTE 159 # 1Glen Carbon, IL 62034-1907
Mailing Address4955 S State Route 159 # 1Glen Carbon, IL 62034-1907 · (618) 288-7855 · Fax (618) 288-7866
Phone(618) 288-7855
Fax(618) 288-7866
Organization SubpartNo
Authorized OfficialRyan S DiederichOwner · (618) 288-7855
Enumeration DateMay 24, 2022
NPPES CertifiedMay 24, 2022
✔ NPI 1639817182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition
A surgeon who specializes in plastic and reconstructive surgery.
4955 S STATE ROUTE 159 # 1, Glen Carbon, IL 62034
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Other Names 1

Doing Business AsMidamerica Plastic Surgery

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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 S. Diederich, MD PC's NPI number?

The NPI number for Ryan S. Diederich, MD PC is 1639817182. It was assigned to this organization in the NPPES registry on May 24, 2022. The provider is doing business as MidAmerica Plastic Surgery.

Where is Ryan S. Diederich, MD PC located?

Ryan S. Diederich, MD PC is located at 4955 S State Route 159 # 1, Glen Carbon, IL 62034. The listed phone number is (618) 288-7855.

What is Ryan S. Diederich, MD PC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

What insurance does Ryan S. Diederich, MD PC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Ryan S. Diederich, MD PC 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.

When was this NPI record last updated?

The NPPES record for Ryan S. Diederich, MD PC was last updated on May 24, 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.