| Jennifer H Rysso, | |
|
4695 Shoreline Dr, Spring Park, MN 55384-9715 | |
| (952) 442-7890 | |
| (952) 442-7894 |
| Full Name | Jennifer H Rysso |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 32 Years |
| Location | 4695 Shoreline Dr, Spring Park, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033195813 | NPI | - | NPPES |
| 318902300 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 39203 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kaiser Foundation Hospital - West La | Los angeles, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern California Permanente Medical Group | 6002729175 | 9038 |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer H Rysso, 4695 Shoreline Dr, Spring Park, MN 55384-9715 Ph: (952) 442-7890 | Jennifer H Rysso, 4695 Shoreline Dr, Spring Park, MN 55384-9715 Ph: (952) 442-7890 |
James D Lehmann, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7895 Fax: 952-442-7894 | |
Thomas G Stocks, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7890 Fax: 952-442-7893 | |
Kevin M White, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7895 Fax: 952-442-7894 | |
Eric A Nagle, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4695 Shoreline Dr, Spring Park, MN 55384 Phone: 952-442-7890 Fax: 952-442-7894 |