Individual provider Active NPI

Luke William Ryan, PA-C

  • Physician Assistant
  • Johnston, IA
National Provider Identifier
1255034120
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
127972 Issued in IA
Practice address
5615 NW 86TH St
Johnston, IA 50131-1738
Phone
(515) 643-6000
Fax
(515) 643-6001
NPI assigned
Mar 22, 2023
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 127972 IA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5615 NW 86TH St
Johnston, IA 50131-1738

Mailing address

PO Box 674721
Dallas, TX 75267-4721
Phone (515) 643-2519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240930001859 IA Practitioner - Physician Assistant 9133650393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1601 NW 114TH St
255 Mercyone Urgent Care
Clive, IA 50325-7036
Phone (515) 461-9780

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc Current Accepting new patients
Mercy Clinics, Inc. CurrentSince Sep 16, 2024 Accepting new patients
Mercy Clinics, Inc. CurrentSince Sep 16, 2024 Accepting new patients
Mercy Clinics, Inc. Past Accepting new patients

Locations

1601 NW 114th St
Ste 255
Clive, IA 50325
Phone (515) 222-7010

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

2006 N 4th St
Ste 200
Indianola, IA 50125
Phone (515) 358-7660

307 E Scenic Valley Ave
Indianola, IA 50125
Phone (515) 961-8448

5615 NW 86th St
Johnston, IA 50131
Phone (515) 223-5466

Interoperability endpoints

  • Direct secure messaging: lryan3956456@direct.trinity-health.org

Organizations & group practices 5

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 4

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1255034120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674721",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674721",
            "telephone_number": "515-643-2519",
            "fax_number": "515-643-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 NW 86TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311738",
            "telephone_number": "515-643-6000",
            "fax_number": "515-643-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "LUKE",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "127972",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

Verify at the official NPI Registry.