DR. JESSE RYAN WYATT M.D.
NPI 1508205154
Pediatrics - Pediatric Critical Care Medicine in Ventura, CA

Active since June 17, 2013PECOS Enrolled
300 HILLMONT AVE, VENTURA, CA 93003(805) 652-6000 Get Directions Write a Review

NPPES record last updated: March 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 18, 2025, Jul 31, 2018, Jun 25, 2018 and 1 more (4 updates tracked since 2018).

About Dr. Jesse Ryan Wyatt M.d. NPPES

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

DR. JESSE RYAN WYATT M.D. (NPI 1508205154) is an individual pediatric critical care medicine provider in Ventura, California, licensed in California (A126356) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508205154
Entity TypeIndividualMale
Primary Taxonomy2080P0203X
Provider Legal NameDR. JESSE RYAN WYATTCredential: M.D.
Location Address300 HILLMONT AVEVentura, CA 93003
Mailing Address11234 Anderson St, Gme Office Westerly Suite 'c'Loma Linda, CA 92354-2804 · (909) 558-4174
Sole ProprietorNo
Enumeration DateJune 17, 2013
Last NPPES UpdateMarch 18, 20254 updates tracked since enumeration
NPPES CertifiedMarch 18, 2025
NPI 1508205154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License Licensed in CA · A126356
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedPediatricsTaxonomy 208000000X · License A126356 (CA)
300 HILLMONT AVE, Ventura, CA 93003

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jesse Ryan Wyatt M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

Case Manager/Care Coordinator
300 HILLMONT AVE
VENTURA, CA 93003
Nurse Practitioner (Family)
300 HILLMONT AVE, BLDG 340, STE 401
VENTURA, CA 93003
Counselor (Mental Health)
300 HILLMONT AVE
VENTURA, CA 93003
Case Manager/Care Coordinator
300 HILLMONT AVE
VENTURA, CA 93003
Registered Nurse
300 HILLMONT AVE
VENTURA, CA 93003
Student in an Organized Health Care Education/Training Program
300 HILLMONT AVE
VENTURA, CA 93003
Internal Medicine (Hematology & Oncology)
300 HILLMONT AVE, BLDG 340, STE 501
VENTURA, CA 93003
Pathology (Anatomic Pathology & Clinical Pathology)
300 HILLMONT AVE
VENTURA, CA 93003

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 Jesse Wyatt's NPI number?

The NPI number for Jesse Wyatt is 1508205154. It was assigned to this individual provider in the NPPES registry on June 17, 2013.

Where is Jesse Wyatt located?

Jesse Wyatt practices at 300 Hillmont Ave, Ventura, CA 93003. The listed phone number is (805) 652-6000.

What is Jesse Wyatt's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Jesse Wyatt enrolled in Medicare?

Yes. Jesse Wyatt is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jesse Wyatt was last updated on March 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.