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MR. RYAN ANTHONY WONG MD
NPI 1023699931
Urology in Lake St Louis, MO

Active since April 21, 2021PECOS Enrolled
300 MEDICAL PLZ STE 310, LAKE ST LOUIS, MO 63367(636) 625-2662(636) 625-1121 Get Directions Write a Review

NPPES record last updated: August 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 26, 2026, Apr 21, 2021 (2 updates tracked since 2021).

About Mr. Ryan Anthony Wong Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RYAN ANTHONY WONG MD (NPI 1023699931) is an individual urology provider in Lake St Louis, Missouri, licensed in Missouri (2026036272) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Saint Louis, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1023699931
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameMR. RYAN ANTHONY WONGCredential: MD
Location Address300 MEDICAL PLZ STE 310Lake St Louis, MO 63367-1484
Mailing Address1465 S Grand Blvd Rm 2717Saint Louis, MO 63104-1003 · (314) 268-4070 · Fax (314) 268-4019
Phone(636) 625-2662
Fax(636) 625-1121
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 21, 2021
Last NPPES UpdateAugust 26, 20262 updates tracked since enumeration
NPPES CertifiedAugust 26, 2026
✔ NPI 1023699931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in MO · 2026036272
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
300 MEDICAL PLZ STE 310, Lake St Louis, MO 63367
Open in Google Maps ↗

Secondary Practice Location 1

Location 11465 S Grand Blvd Rm 2717Saint Louis, MO 63104-1003 · Phone (314) 268-4070 · Fax (314) 268-4019

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Ryan Anthony Wong Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103229232
PECOS Enrollment IDI20260721001137
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ryan Wong reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ssm Medical Group, Inc.
2.3 mi
Clinic/Center
1101 HIGHWAY K STE A
O Fallon, MO 63366
  • Reassigned Medicare billing, Missouri enrollment
  • 697 clinicians in this Medicare group
NPI 1851896146 (844) 766-7200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63367 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACLYN MORRIS CPNP-PC
Nurse Practitioner (Pediatrics)
300 MEDICAL PLZ STE 310
LAKE SAINT LOUIS, MO 63367
St. Charles County (636) 625-2662
DR. THOMAS HAROLD LANDON MD
Urology
300 MEDICAL PLZ STE 310
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
CHARLES ROBERT HARTMAN JR. DO
Surgery
300 MEDICAL PLZ STE 310
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
DR. THOMAS MARK LEIBOLD MD
Surgery
300 MEDICAL PLZ STE 310
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
DR. DAVID A. NICKEL M.D.
Surgery
300 MEDICAL PLZ STE 310
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
KAMRAN QURESHI MD
Internal Medicine (Gastroenterology)
300 MEDICAL PLZ STE 310
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
MARISA LYNCH PA-C
Physician Assistant
300 MEDICAL PLZ STE 310
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-2662
DR. JOSEPH FRANKLIN RODEMANN MD
Internal Medicine (Gastroenterology)
300 MEDICAL PLZ STE 310
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-0600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ryan Wong's NPI number?

The NPI number for Ryan Wong is 1023699931. It was assigned to this individual provider in the NPPES registry on April 21, 2021.

Where is Ryan Wong located?

Ryan Wong practices at 300 Medical Plz Ste 310, Lake St Louis, MO 63367. The listed phone number is (636) 625-2662.

What is Ryan Wong's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Ryan Wong enrolled in Medicare?

Yes. Ryan Wong is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ryan Wong's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Wong reassigns Medicare benefits to Ssm Medical Group, Inc. (O Fallon, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ryan Wong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ryan Wong was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.