Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ryan Edward Elassal, PT

Individual provider Physical Therapist · NPI 1417587676

Ryan Edward Elassal, PT is a Physical Therapist in Private Practice in Oklahoma City, Oklahoma. Qualified in 2017, 9 years ago. Practices with Boomer 06 PLLC, a 4-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
9
Licensed in
OK
In the registry since
2020
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

7919 Mid America Blvd Ste 100
Oklahoma City, OK 73135-6611
Phone: (405) 736-0064
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X · Licence 1-E-8553 (OK)
Physical Therapist Taxonomy 225100000X · Licence 5329 (OK)

Record details

NPI number1417587676
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedJanuary 16, 2020
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Boomer 06 Pllc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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