Ryan Otto
Ryan Otto is a Physician Assistant in Kenosha, Wisconsin. Qualified in 2022, 4 years ago. Practices with Prohealth Medical Group Inc, a 472-clinician group and accepts Medicare assignment. Licensed in Illinois and Wisconsin.
- Years since qualifying
- 4
- Licensed in
- IL, WI
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
1400 43rd StKenosha, WI 53140-2741
Phone: (414) 651-2814
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 8206 (WI) |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X · Licence IL (IL) |
Record details
| NPI number | 1457004517 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | January 30, 2022 |
| Last updated in NPPES | March 16, 2026 |
| Certification date | March 16, 2026 |
| Mailing address | 1400 43rd St, Kenosha, WI 53140-2741 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2022 (4 years in practice) |
| Group practice | Prohealth Medical Group Inc — 472 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Kenosha
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Emily Ellen Fulk, PA-C
3400 Market Ln, Kenosha, WI 53144-3430 · (262) 551-4600
-
Jerrilyn Johnson, PA-C
8501 75th St Ste J, Kenosha, WI 53142-7602 · (262) 898-4400
-
Megan Irene Kremiller, PA
10400 75th St, Kenosha, WI 53142-7884 · (262) 948-5600
-
Andrea M Mattison, PAC
3400 Market Ln, Kenosha, WI 53144-3430 · (262) 551-4600
-
Mr. Manuel Alejandro Sanchez, PHYSICIANASSISTANT
10400 75th St, Kenosha, WI 53142-7884 · (262) 948-5600