Individual provider Active NPI

Ryan Stilwell, PA-C

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1629598255
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57018 Issued in CA
Practice address
1745 N Broadway Ste 101
Santa Maria, CA 93454
Phone
(805) 739-3890
Fax
(805) 347-7697
NPI assigned
Jun 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57018 CA Primary

Addresses

Primary practice location

1745 N Broadway Ste 101
Santa Maria, CA 93454

Mailing address

1745 N Broadway Ste 101
Santa Maria, CA 93454-1940
Phone (805) 739-3890

Other practice location 1

2271 S. Depot Street
Santa Maria, CA 93455
Phone (805) 922-0561

Other practice location 2

1102 E Clark Ave Ste 120A
Santa Maria, CA 93455-5175
Phone (805) 332-8185

Other practice location 3

877 Oak Park Blvd
Pismo Beach, CA 93449-3292
Phone (805) 474-8450

Other practice location 4

5920 West Mall
Atascadero, CA 93422-4232
Phone (805) 466-0676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191111000766 CA Practitioner - Physician Assistant 3173898319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

1510 E Main St
Suite 104 C
Santa Maria, CA 93454-4825
Phone (805) 349-8514

1745 N Broadway
Suite 101
Santa Maria, CA 93454-1940
Phone (805) 739-3890

Hospital & facility affiliations

  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Oct 14, 2019 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Oct 14, 2019 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

5920 West Mall
Atascadero, CA 93422
Phone (805) 466-0676

877 Oak Park Blvd
Pismo Beach, CA 93449
Phone (805) 473-2200

1400 E Church St
Ofc
Santa Maria, CA 93454
Phone (805) 739-3112

1745 N Broadway
Ste 101
Santa Maria, CA 93454

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

1102 E Clark Ave
Ste 120A
Santa Maria, CA 93455
Phone (805) 332-8185

2271 S Depot St
Santa Maria, CA 93455
Phone (805) 922-0561

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1629598255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 N BROADWAY STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934541940",
            "telephone_number": "805-739-3890",
            "fax_number": "805-347-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 N BROADWAY STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-739-3890",
            "fax_number": "805-347-7697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2271 S. Depot Street",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "93455",
            "country_code": "US",
            "telephone_number": "805-922-0561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 E Clark Ave Ste 120A",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934555175",
            "country_code": "US",
            "telephone_number": "805-332-8185",
            "fax_number": "805-332-8186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "877 Oak Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934493292",
            "country_code": "US",
            "telephone_number": "805-474-8450",
            "fax_number": "805-474-8454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5920 West Mall",
            "address_purpose": "LOCATION",
            "city": "Atascadero",
            "state": "CA",
            "postal_code": "934224232",
            "country_code": "US",
            "telephone_number": "805-466-0676",
            "fax_number": "805-466-4862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILWELL",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-24",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.