Individual provider Active NPI

Ryan McLean Walsh, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1528533825
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64860 Issued in CA
Practice address
1454 University VLG
Salt Lake City, UT 84108-3518
Phone
(385) 775-4354
NPI assigned
Oct 12, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X
Physician Assistant 363A00000X PA64860 CA Primary

Addresses

Primary practice location

1454 University VLG
Salt Lake City, UT 84108-3518

Mailing address

4646 S Zenia Meadows CT
Salt Lake City, UT 84107-4117
Phone (385) 775-4405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, CA, UT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200428002214 ID Practitioner - Physician Assistant 2567892813 Reassigns benefits to 4 organizations
I20241226002536 CA Practitioner - Physician Assistant 2567892813 Reassigns benefits to 1 organization
I20260316003267 UT Practitioner - Physician Assistant 2567892813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64860CAMDGeneral Practice Dentistry
PA64860CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Nov 7, 2024 Accepting new patients
University of Utah Community Physicians Group CurrentSince Jan 31, 2026 Accepting new patients
Sterling Provider Group Single Specialty CurrentSince Aug 11, 2022 Accepting new patients
Urgent Care Associates PLLC Single Specialty Current Accepting new patients
Sterling Provider Group Single Specialty CurrentSince Aug 11, 2022 Accepting new patients
Cep America LLC Single Specialty CurrentSince Jul 1, 2024 Accepting new patients
Cep America, LLC CurrentSince Jul 1, 2024 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince May 1, 2020 Accepting new patients
Inland Cardiology Associates, P.S. Single Specialty Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

1129 S Broadway Ave
Boise, ID 83706
Phone (208) 795-9790

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

10965 W Overland Rd
Boise, ID 83709
Phone (208) 900-9901

6965 N Glenwood St
Boise, ID 83714
Phone (208) 853-3000

1404 Pomerelle Ave
Ste A1
Burley, ID 83318
Phone (208) 878-8783

5605 Northside Xing
Chubbuck, ID 83202
Phone (208) 547-5062

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

507 S Main St
Hailey, ID 83333
Phone (208) 788-0061

7017 Daisy Ln
Idaho Falls, ID 83402
Phone (208) 534-5878

740 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 542-9111

2201 Thain Grade
Lewiston, ID 83501
Phone (208) 717-3100

1693 S Meridian Rd
#110
Meridian, ID 83642

3185 E Ustick Rd
Meridian, ID 83646
Phone (208) 296-7100

1610 Caldwell Blvd
Nampa, ID 83651
Phone (208) 207-8500

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

900 N Highway 41
Ste 2
Post Falls, ID 83854
Phone (208) 457-7100

130 W Main St
Rexburg, ID 83440
Phone (208) 356-8818

939 S State Highway 89
Ste 1
Logan, UT 84321
Phone (435) 787-8504

630 E 1400 N
Ste 150
North Logan, UT 84341
Phone (435) 787-8504

609 S Highway 91
Ste A
Richmond, UT 84333

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

Interoperability endpoints

  • Direct secure messaging: rwalsh888041@ahs.direct-ci.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1528533825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 S ZENIA MEADOWS CT",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841074117",
            "telephone_number": "385-775-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 UNIVERSITY VLG",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841083518",
            "telephone_number": "385-775-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "RYAN",
        "middle_name": "MCLEAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-12",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.