Dr Kelly W Ryder, DO - Medicare Internal Medicine in Hattiesburg, MS

Dr Kelly W Ryder, DO is a medicare enrolled "Internal Medicine" physician in Hattiesburg, Mississippi. He graduated from medical school in 2005 and has 19 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Pine Ridge Indian Health Service Hospital and his current practice location is 415 S 28th Ave, Hattiesburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 288-4329.

Dr Kelly W Ryder is licensed to practice in Mississippi (license number 22127) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1083866651.

Contact Information

Dr Kelly W Ryder, DO
415 S 28th Ave,
Hattiesburg, MS 39401-7246
(601) 288-4329
Not Available



Physician's Profile

Full NameDr Kelly W Ryder
GenderMale
SpecialityInternal Medicine
Experience19 Years
Location415 S 28th Ave, Hattiesburg, Mississippi
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Kelly W Ryder graduated from medical school in 2005
  NPI Data:
  • NPI Number: 1083866651
  • Provider Enumeration Date: 10/15/2008
  • Last Update Date: 07/11/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 7719038512
  • Enrollment ID: I20221206002474

Medical Identifiers

Medical identifiers for Dr Kelly W Ryder such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083866651NPI-NPPES
302I116827OtherMSMEDICARE PTAN
6576308OtherMSCIGNA
9826619OtherMSAETNA
P01109812OtherMSRAILROAD MEDICARE
3226035OtherMSUNITED HEALTHCARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208M00000XHospitalist 22127 (Mississippi)Secondary
208M00000XHospitalist 2030 (Tennessee)Secondary
207R00000XInternal Medicine 22127 (Mississippi)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Pine Ridge Indian Health Service Hospital468857132693

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kelly W Ryder allows following entities to bill medicare on his behalf.
Entity NamePine Ridge Indian Health Service Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497786412
PECOS PAC ID: 4688571326
Enrollment ID: O20031218000966

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelly W Ryder is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Kelly W Ryder, DO
415 S 28th Ave,
Hattiesburg, MS 39401-7246

Ph: (601) 288-4329
Dr Kelly W Ryder, DO
415 S 28th Ave,
Hattiesburg, MS 39401-7246

Ph: (601) 288-4329

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Internal Medicine Doctors in Hattiesburg, MS

Laurie Evans Douglas, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 301 S 28th Ave, Hattiesburg, MS 39401
Phone: 601-261-1700    Fax: 601-288-8290
Dr. Charles Ramsey Mccollum Iii, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401
Phone: 601-268-5650    Fax: 601-579-5212
Porter Hudson Glover, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401
Phone: 601-268-5680    Fax: 601-268-5778
Alex Gauthier,
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 5001 Hardy St, Hattiesburg, MS 39402
Phone: 601-268-8000    
Grettel Rodriguez Garcia,
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 31 Woodstone Dr, Hattiesburg, MS 39402
Phone: 347-342-2441    
Ms. Manal Mohammad Abdur Rahman, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 7 Medical Blvd, Hattiesburg, MS 39401
Phone: 601-296-2990    Fax: 601-296-2860
Dr. Vashishtha Patel, DO
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 5001 Hardy St, Hattiesburg, MS 39402
Phone: 704-733-7499    

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