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

Rylee Hackworth, PA

Individual provider Medical Physician Assistant · NPI 1063104719

Rylee Hackworth, PA is a Physician Assistant in Lagrange, Indiana. Qualified in 2024, 2 years ago. Practices with Northeast Internal Medicine Associates, PC, a 53-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
2
Licensed in
IN
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

2500 N Detroit St
Lagrange, IN 46761-1158
Phone: (260) 463-2133
Fax: (260) 463-3775
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10004694A (IN)

Record details

NPI number1063104719
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 22, 2023
Last updated in NPPESJanuary 9, 2025
Certification dateJanuary 9, 2025
Mailing addressPo Box 236, Lagrange, IN 46761-0236

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Northeast Internal Medicine Associates, Pc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount