Individual provider Active NPI

Rylan Wikle

  • Physician Assistant
  • Lorain, OH
National Provider Identifier
1073341020
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3600 Kolbe Rd
Lorain, OH 44053-1654
Phone
(440) 930-6015
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X OH Primary

Addresses

Primary practice location

3600 Kolbe Rd
Lorain, OH 44053-1654

Mailing address

3600 Kolbe Rd Ste 100
Lorain, OH 44053-1652
Phone (440) 930-6015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023003307 OH Practitioner - Physician Assistant 6608309091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lorain Specialty Care LLCGroup PAC ID 4688070055, 134 clinicians

Practice addresses (Care Compare)

578 N Leavitt Rd
Amherst, OH 44001-1131
Phone (440) 960-3912

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lorain Specialty Care LLC Single Specialty CurrentSince Sep 22, 2024 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Sep 22, 2024 Accepting new patients

Locations

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

3600 Kolbe Rd
Ste 100
Lorain, OH 44053
Phone (440) 222-4970

3600 Kolbe Rd
Lorain, OH 44053
Phone (440) 282-5100

Interoperability endpoints

  • Direct secure messaging: rwikle2692436@direct.bsmhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1073341020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 KOLBE RD STE 100",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531652",
            "telephone_number": "440-930-6015",
            "fax_number": "440-930-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531654",
            "telephone_number": "440-930-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIKLE",
        "first_name": "RYLAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.