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

Ryan Wilson, PA

Individual provider Physician Assistant · NPI 1174980346

Ryan Wilson, PA is a Physician Assistant in Meridian, Idaho. Qualified in 2015, 11 years ago. Practices with Boise Radiology Group PLLC, a 63-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
11
Licensed in
ID
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1623 S Wells Ave
Meridian, ID 83642-5040
Phone: (208) 489-1450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3277 E Louise Dr Ste 100, Meridian, ID 83642-9360 — (208) 706-7086

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-1341 (ID)

Record details

NPI number1174980346
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 19, 2016
Last updated in NPPESJune 16, 2022
Certification dateJune 16, 2022
Mailing addressPo Box 191050, Boise, ID 83719-1050

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 Boise Radiology Group Pllc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Meridian