Ryan S. Diederich, MD PC
NPI 1639817182ActiveOrganization· Surgery, Plastic and Reconstructive Surgery· Glen Carbon, IL
Surgery, Plastic and Reconstructive Surgery in Glen Carbon, Illinois, registered in NPPES in May 2022. The authorized official on file is Ryan S. Diederich, MD, Owner.
Overview
| NPI | 1639817182 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 24, 2022 |
| Last updated in NPPES | May 24, 2022 |
| Certified by provider | May 24, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Plastic and Reconstructive Surgery Primary | 2086S0122X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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