NPIMap

Individual provider Active NPI

Ryan Patrick Wippler, M.D.

  • Diagnostic Radiology Physician
  • Duluth, MN
National Provider Identifier
1205037538
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
57492 Issued in MN
Practice address
420 E 1St St
Duluth, MN 55805-1901
Phone
(218) 786-8364
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 57492 MN Primary

Addresses

Primary practice location

420 E 1St St
Duluth, MN 55805-1901

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140603000705 MN Practitioner - Diagnostic Radiology 2668695073 Reassigns benefits to 2 organizations
I20230201001010 WI Practitioner - Diagnostic Radiology 2668695073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, shared by 25 NPIs, 1,135 clinicians

Practice addresses (Care Compare)

1615 Maple LN
Suite 1
Ashland, WI 54806-3630
Phone (715) 685-7500

420 E 1St St
Duluth, MN 55805-1901
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Oct 22, 2022 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Feb 14, 2022 Accepting new patients
The Duluth Clinic, LTD CurrentSince Feb 14, 2022 Accepting new patients
Brainerd Medical Center Inc. CurrentSince Jul 1, 2022 Accepting new patients
Brainerd Medical Center Inc CurrentSince Jul 1, 2022 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
The Duluth Clinic, LTD CurrentSince Oct 22, 2022 Accepting new patients

Locations

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

1615 Maple Ln
Ste 1
Ashland, WI 54806
Phone (715) 685-7500

15495 County Road B
Hayward, WI 54843
Phone (715) 634-2641

11134 N State Road 77
Hayward, WI 54843
Phone (715) 634-5505

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 9

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

Hospital & facility affiliations 9

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1205037538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051901",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIPPLER",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "57492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.