RYAN M WILSON (PA) – Physician Assistant, NPI 1306811567

RYAN M WILSON (PA) is a healthcare provider. based in Melbourne, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. P9102044 (FL). The NPI Number for RYAN M WILSON (PA) is 1306811567

Main info

Male
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
RYAN M WILSON (PA)
NPI
1306811567
Phone
(321) 434-1401
Address
1350 Hickory St Ste 101
Enumeration Date
21 February 2006
Last Update Date
1 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
8820033038
Group Practice PAC ID
7416100672
Professional Enrollment ID
I20050628000068
Address ID
FL329313562CO699XXCSWY500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for RYAN M WILSON (PA)

  • 1350 Hickory St Ste 101

    Melbourne, FL 329013224

    Phone: (321) 434-1401

    Fax: (321) 434-1667

    Type: Location

  • Health First Business Center (Bldg A), 3300, South Fiske Boulevard, Rockledge, Brevard County, Florida, 32955, United States

    ROCKLEDGE, FL 329554306

    Phone:

    Type: Mailing

  • 1350 HICKORY ST

    MELBOURNE, FL 329013224

    Phone: (321) 434-1401

    Fax: (321) 434-1667

    Type: Location

  • 1350, Hickory Street, Melbourne, Brevard County, Florida, 32901, United States

    SUITE PSO

    MELBOURNE, FL 329013224

    Phone: (321) 434-1401

    Fax: (321) 434-1667

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-06-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050628000068IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes2725$0
99221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes2323$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes1818$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1717$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 32901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416100672View full group profile
NameSpecialtyState
Diagnostic RadiologyFL
-FL
-FL
-FL
Physical Medicine And RehabilitationFL
Family PracticeFL
G A S T R O E N T E R O L O G YFL
-FL
G A S T R O E N T E R O L O G YFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is RYAN M WILSON (PA)'s NPI number?
RYAN M WILSON (PA)'s NPI is 1306811567 — the number used across U.S. healthcare to identify this provider.
Is RYAN M WILSON (PA) still an active registrant?
RYAN M WILSON (PA) carries an active NPI according to the public dataset.
What clinical focus is listed for RYAN M WILSON (PA)?
At a glance, RYAN M WILSON (PA) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Florida is RYAN M WILSON (PA) registered?
Use Melbourne, Florida as the headline location for RYAN M WILSON (PA) here.
When was this NPI issued?
Enumeration for RYAN M WILSON (PA) is noted as February 21, 2006 where the registry provides it.

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