Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ryan Martin Lawrence, PA-C

Individual provider Physician Assistant · NPI 1164813499

Ryan Martin Lawrence, PA-C is a Physician Assistant in Oak Creek, Wisconsin. Qualified in 2014, 12 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
12
Licensed in
WI
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

200 E Ryan Rd
Oak Creek, WI 53154-4563
Phone: (414) 570-3590
Fax: (414) 570-3599
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • N15w28300 Golf Rd, Pewaukee, WI 53072-4800 — (262) 303-5055

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3491-23 (WI)

Record details

NPI number1164813499
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 9, 2015
Last updated in NPPESAugust 2, 2024
Certification dateAugust 2, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Oak Creek