MEDICARE: RYAN JOHN HERRINGA M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	55651	WI
2	2084P0800X	Psychiatry Physician	55651	WI

General Provider Information

NPI Number	:	1528225711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN JOHN HERRINGA M.D., PH.D.

Provider Business Mailing Address
First Line	:	5101 CONEY WESTON PL
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-1105
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 FORWARD DR
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-2443
Country	:	US
Telephone Number	:	608-320-3232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	10/28/2025

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