Ryan Otto
NPI 1457004517ActiveIndividual· Physician Assistant· Kenosha, WI
Physician Assistant with Prohealth Medical Group Inc, practicing in Kenosha, Wisconsin. Part D covered 600 prescriptions written in 2024, 88% of them generic. Lists Amita Health Resurrection Medical Center and 2 other hospitals as hospital affiliations.
Overview
| NPI | 1457004517 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jan 30, 2022 |
| Last updated in NPPES | Mar 16, 2026 |
| Certified by provider | Mar 16, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 8206 | WI |
| Physician Assistant, Medical | 363AM0700X | IL | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (IL); Practitioner - Physician Assistant (WI) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 600 · 1,286 30-day fills |
|---|---|
| Patients | 104 |
| Total drug cost | $63,865 |
| Generic share | 88% of claims |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Prohealth Medical Group IncMukwonago, WI · 479 clinicians
Hospital affiliations
- Amita Health Resurrection Medical CenterChicago, IL
- Presence Saints Mary and Elizabeth Medical CenterChicago, IL
- Waukesha Memorial HospitalWaukesha, WI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 50 physician assistants in Kenosha · All physician assistants in Wisconsin