Ryan M Wilson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

P9102044 Issued in FL

Practice address

1350 Hickory St
Melbourne, FL 32901-3224

Phone

(321) 434-1401

Fax

(321) 434-1667

NPI assigned

Feb 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Health First Physician Specialties IncGroup PAC ID 9537229646, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
• Viera Hospital Hospital, Melbourne, FL, CCN 100315
• Parrish Medical Center Hospital, Titusville, FL, CCN 100028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwilson23032@epicdirect.hf.org

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.

• Health First Medical Group, LLC

  • General Practice Physician
  • Melbourne, FL
  • NPI 1750626495
  Medicare reassignment Care Compare group NPD
• Health First Physician Specialties Inc

  • Orthopaedic Trauma Physician
  • Melbourne, FL
  • NPI 1336390020
  Medicare reassignment Care Compare group
• Health First Medical Group, LLC

  • General Practice Physician
  • Rockledge, FL
  • NPI 1073268934
  NPD

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

• Holmes Regional Medical Center, Inc.

  dba First Flight

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation
• North Brevard County Hospital District

  dba Parrish Medical Center

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648
  Care Compare affiliation
• Viera Hospital Inc

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1730494816
  Care Compare affiliation

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1306811567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "321-434-1401",
            "fax_number": "321-434-1667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Hickory St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-434-1401",
            "fax_number": "321-434-1667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RYAN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "P9102044",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9102044",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "E8442U",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00466915",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291346100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Ann Ortega Wilson, DPM
• Joseph Wilson
• Lisett Irina Wilson
• Nicholas Wilson, LCSW
• Richard C Wilson, DPM
• Savannah A. Wilson
• Thomas Charles Wilson, DPM
• Natalia Wiltshire
• Myo Win, MD
• Sein Win, MD

• Physician Assistant in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.