Ryan Edward Elassal, PT
NPI 1417587676ActiveIndividual· Durable Medical Equipment & Medical Supplies· Oklahoma City, OK
Durable Medical Equipment & Medical Supplies (PT) with Boomer 06 PLLC, practicing in Oklahoma City, Oklahoma. Medicare paid $71,149 for services to 102 patients in 2024.
Overview
| NPI | 1417587676 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | Yes |
| NPI issued | Jan 16, 2020 |
| Last updated in NPPES | Sep 24, 2024 |
| Certified by provider | Sep 24, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Durable Medical Equipment & Medical Supplies Primary | 332B00000X | 1-E-8553 | OK |
| Physical Therapist | 225100000X | 5329 | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (OK) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 102 |
|---|---|
| Services billed | 3,238 across 10 procedure codes |
| Paid by Medicare | $71,149 |
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Boomer 06 PLLCOklahoma City, OK · 4 clinicians
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