Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ryan Gaston Leckner

Individual provider Physician Assistant · NPI 1154157907

Ryan Gaston Leckner is a Physician Assistant in South Lyon, Michigan. Qualified in 2025, 1 year ago. Practices with Pain Specialists of Charleston, a 17-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2024

Practice location Address checks out

22655 Indianwood Dr
South Lyon, MI 48178-9420
Phone: (248) 880-0878
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1154157907
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 9, 2024
Last updated in NPPESSeptember 9, 2024
Certification dateSeptember 9, 2024
Mailing address22655 Indianwood Dr, South Lyon, MI 48178-9420

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Pain Specialists Of Charleston — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in South Lyon