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

Ryan Grange, PA

Individual provider Medical Physician Assistant · NPI 1295194629

Ryan Grange, PA is a Physician Assistant in Edgewood, New Mexico. Qualified in 2015, 11 years ago. Practices with Presbyterian Healthcare Services, a 1,375-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Mexico.

Years since qualifying
11
Licensed in
NM
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1851 Old Highway 66 Unit 1
Edgewood, NM 87015
Phone: (505) 286-2396
Fax: (505) 286-2398
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA 2016-0016 (NM)

Record details

NPI number1295194629
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 12, 2016
Last updated in NPPESApril 14, 2016
Mailing address12127b Hwy 14 N, Ste 5, Cedar Crest, NM 87008-9499

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Presbyterian Healthcare Services — 1375 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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