Ryan W Clark (NPI# 1720499759, PAC ID# 9537467576) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1720499759 |
| PAC ID by PECOS | 9537467576 |
| Professional Enrollment ID | I20180911000823 |
| Full Name | Ryan W Clark |
| Organization Legal Name | AURORA ADVANCED HEALTHCARE INC |
| Address |
6425 W Mequon Rd Mequon WI 53092-1855 |
| Phone Number | 2622420051 |
| Gender | M |
| Medical School | WESTERN UNIV OF HEALTH SCIENCES COL OF DENTAL MED, POMONA CA |
| Graduation Year | 2013 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 3375625833 |
| Number of Group Practice Members | 854 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520207 | AURORA MEDICAL CENTER - GRAFTON |
| 520038 | AURORA MEDICAL CTR WASHINGTON COUNTY |
| 520138 | AURORA ST LUKES MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 6425 W Mequon Rd, Mequon, WI 53092-1855 | 2622420051 | AURORA ADVANCED HEALTHCARE INC |
| Organization Legal Name | AURORA ADVANCED HEALTHCARE INC |
| Physicians | 907 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Abdulrehman Siddiqui | Family Medicine | Aurora Advanced Healthcare Inc | 12203 N Corporate Pkwy, Mequon, WI 53092-3388 |
| Alisa Orel | Registered Dietitian Or Nutrition Professional | Aurora Advanced Healthcare Inc | 215 W Washington St, Grafton, WI 53024-1700 |
| Stephanie K Covey | Family Medicine | Aurora Advanced Healthcare Inc | 3055 Hubertus Rd, Hubertus, WI 53033-9642 |
| Troy A Hurst | Physical Therapy | Aurora Advanced Healthcare Inc | N112 W17975 Mequon Rd, Germantown, WI 53022-2425 |
| Savan Panchal | Family Medicine | Aurora Advanced Healthcare Inc | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 |
| Ann B Cates | Physical Therapy | Aurora Advanced Healthcare Inc | 4848 S 76th St, Suite 210, Greenfield, WI 53220-4361 |
| Brittany A Frisque | Nurse Practitioner | Aurora Advanced Healthcare Inc | 1640 E Sumner St, Hartford, WI 53027-2684 |
| Megan M Rorabeck | Physical Therapy | Aurora Advanced Healthcare Inc | 9200 W Loomis Rd, Suite 101, Franklin, WI 53132-5313 |
| Ryan M Lawrence | Physician Assistant | Aurora Advanced Healthcare Inc | 9120 W Loomis Rd, Suite 100, Franklin, WI 53132-9083 |
| Krista M Dyreson | Family Medicine | Aurora Advanced Healthcare Inc | 6425 W Mequon Rd, Mequon, WI 53092-1855 |
| Street Address |
6425 W MEQUON RD |
| City | MEQUON |
| State | WI |
| Zip | 53092-1855 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Krista M Dyreson | Family Medicine | Aurora Advanced Healthcare Inc | 6425 W Mequon Rd, Mequon, WI 53092-1855 |
| John J Yang | Family Medicine | Aurora Advanced Healthcare Inc | 6425 W Mequon Rd, Mequon, WI 53092-1855 |
| Andrea R Enters | Nurse Practitioner | Aurora Advanced Healthcare Inc | 6425 W Mequon Rd, Mequon, WI 53092-1855 |
| Britani R Weidman | Nurse Practitioner | Aurora Advanced Healthcare Inc | 6425 W Mequon Rd, Mequon, WI 53092-1855 |
| Anne L Mattson | Family Medicine | Aurora Advanced Healthcare Inc | 6425 W Mequon Rd, Mequon, WI 53092-1855 |
| Nusrat Kalloo | Geriatric Medicine | Aurora Advanced Healthcare Inc | 6425 W Mequon Rd, Mequon, WI 53092-1855 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bruce C Herman | Internal Medicine | 407 N Main St, Thiensville, WI 53092-1212 | |
| Therese A Jaeckle | Nurse Practitioner | 136 N Main St, Suite 304, Thiensville, WI 53092-1606 | |
| Gary S Lewis | Family Medicine | Independent Physicians of Wisconsin LLC | 136 N Main St, Suite 201, Thiensville, WI 53092-1606 |
| Maria P Fenske | Chiropractic | Prohealth Chiropractic Center Sc | 136 N Main St, Suite 202, Thiensville, WI 53092-1606 |
| James R Shelstad | Chiropractic | Prohealth Chiropractic Center Sc | 136 N Main St, Suite 202, Thiensville, WI 53092-1606 |
| Sarah J Krueger | Psychologist, Clinical | 216 N Green Bay Ave, Suite 108, Thiensville, WI 53092-1625 | |
| Sharon K Thurow | Nurse Practitioner | 216 Green Bay Rd, Suite 101, Thiensville, WI 53092-1625 | |
| Lynn M Fitzsimmons | Psychologist, Clinical | 216 Green Bay Rd, Suite 108, Thiensville, WI 53092-1625 | |
| David B Tick | Internal Medicine | 216 Green Bay Rd, Thiensville, WI 53092-1658 | |
| Molly S Hausmann | Chiropractic | 11203 N Buntrock Ave, Suite 100, Mequon, WI 53092-1857 | |
| Find all physicians in zip 53092 | |||
| City | MEQUON |
| Zip Code | 53092 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | MEQUON + PHYSICAL MEDICINE AND REHABILITATION |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.