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

Ryan Tait Vickers, PA-C, MMS

Individual provider Physician Assistant · NPI 1700264777

Ryan Tait Vickers, PA-C, MMS is a Physician Assistant in Simi Valley, California. Qualified in 2015, 11 years ago. Practices with Synergy Observation Specialists PC, a 32-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone: (805) 955-6000
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 52475 (CA)

Record details

NPI number1700264777
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C , MMS
Sole proprietorNo
NPI enumeratedMay 11, 2015
Last updated in NPPESMay 11, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Synergy Observation Specialists Pc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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