Ryan Daniel Wolfley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2153 Issued in ID

Practice address

444 Hospital Way Ste 477
Pocatello, ID 83201-2744

Phone

(208) 233-7832

Fax

(208) 233-7835

NPI assigned

Oct 28, 2021

Last updated

Jun 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Portneuf Valley Family Center

  • Professional Counselor
  • Pocatello, ID
  • NPI 1174629976
  Medicare reassignment
• Prism Family Medicine LLC

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1942028592
  Medicare reassignment

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1659035301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 HOSPITAL WAY STE 477",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012744",
            "telephone_number": "208-233-7832",
            "fax_number": "208-233-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 HOSPITAL WAY STE 477",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012744",
            "telephone_number": "208-233-7832",
            "fax_number": "208-233-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFLEY",
        "first_name": "RYAN",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-28",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Leo Wise, M.D.
• Kori Ann Wittrock, PHARMD
• Destry Wolbert
• Kari Y Wolbert, LPC
• Haille Jean Wolf
• Laura Wolter
• Pik Ching Wong, LPC
• Alexandrea Kay Wood
• Derek Wood
• Heidi Joy Wood, LCPC

• Physician Assistant in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.