Active NPI
Ryan Willis, PA
- Physician Assistant
- Caro, MI
National Provider Identifier
1891441945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601013051
- Practice address
- 1800 W Caro Rd
Caro, MI 48723-8209 - Phone
- (989) 625-8399
- NPI assigned
- Feb 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601013051 | AZ | Primary |
Addresses
Primary practice location
1800 W Caro Rd
Caro, MI 48723-8209
Mailing address
1800 W Caro Rd
Caro, MI 48723-8209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Barry University School of Podiatric Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
21031 Michigan Ave
Dearborn, MI 48124-2339
Phone 3132776700313
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601013051 | AZ | MD | Physician Assistant |
Interoperability endpoints
- ryan.willis.1@30652.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Dearborn, MI
- NPI 1063516565
-
- Internal Medicine Physician
- Caro, MI
- NPI 1700666708
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754611200000",
"number": "1891441945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 W CARO RD",
"city": "CARO",
"state": "MI",
"postal_code": "487238209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 W CARO RD",
"city": "CARO",
"state": "MI",
"postal_code": "487238209",
"telephone_number": "989-625-8399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "RYAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-28",
"last_updated": "2025-08-08",
"certification_date": "2025-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "5601013051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caro, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.