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

Q: 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.

Q: 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.

Q: 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 19 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.

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: October 18, 2026.

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

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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

Phone(805) 652-6000

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

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Medicare Participation & PECOS CMS

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

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.

Medicare Billing Reassignments

Medicare enrollment records show Jesse Wyatt reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

County Of Ventura

Same address

Federally Qualified Health Center (FQHC)

300 HILLMONT AVE STE 302
Ventura, CA 93003

Reassigned Medicare billing, California enrollment
710 clinicians in this Medicare group

NPI 1619118569 (805) 652-6255

Faculty Physicians And Surgeons Of Llusm

59 mi

Transplant Surgery

1505 WILSON TERRACE, SUITE 155
Glendale, CA 91206

Reassigned Medicare billing, California enrollment
2,584 clinicians in this Medicare group

NPI 1508255175 (909) 558-3636

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

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.

LEIDEE DE LEON

Registered Nurse (Pediatrics)

300 HILLMONT AVE
VENTURA, CA 93003

Ventura County (805) 652-6000

DANIEL FREITAS

Case Manager/Care Coordinator

300 HILLMONT AVE
VENTURA, CA 93003

Ventura County (805) 652-6161

LINDSAY ANN LOFT FNP

Nurse Practitioner (Family)

300 HILLMONT AVE, BLDG 340, STE 401
VENTURA, CA 93003

Ventura County (805) 641-0141

DENNIS J WATSON

Counselor (Mental Health)

300 HILLMONT AVE
VENTURA, CA 93003

Ventura County (805) 562-5907

NATHAN BRODIE

Case Manager/Care Coordinator

300 HILLMONT AVE
VENTURA, CA 93003

Ventura County (805) 652-6161

SEEMA SETH FNP-BC

Nurse Practitioner (Family)

300 HILLMONT AVE
VENTURA, CA 93003

Ventura County (805) 652-3280

MARY E. RASMUSSEN REG.NURSE

Registered Nurse

300 HILLMONT AVE
VENTURA, CA 93003

Ventura County (805) 652-3200

KAYLEE MICHELLE JONES HANTKE

Student in an Organized Health Care Education/Training Program

300 HILLMONT AVE
VENTURA, CA 93003

Ventura County (805) 652-6000

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.

Which organizations bill Medicare for Jesse Wyatt's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Wyatt reassigns Medicare benefits to 2 organizations: County Of Ventura (Ventura, CA) and Faculty Physicians And Surgeons Of Llusm (Glendale, CA). Each 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 Jesse Wyatt'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 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 19 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.