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Active NPI 1134793169 Individual Practitioner Male Practitioner

Gannon Ryan Nyquist , PA-C

Physician Assistant • Vallejo, CA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Gannon Nyquist, PA-C is a certified Physician Assistant practicing in Vallejo, CA. With approximately 4 years of clinical experience since completing medical education in 2022, Gannon Nyquist delivers high-quality medical care to the local community at 1310 CLUB DR.

Gannon Nyquist is affiliated with Providence Health And Services Oregon and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1310 Club Dr

Vallejo, CA 945921187

Telephone 7076385809
Associated Practice Facility / Clinic
🏢 Touro University Facility NPI 1689226565

Medicare Profile & Education

Medical School

Other

Graduation Year

2022

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Vallejo, CA

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs -0.2 yrs vs City Avg
City Avg: 4.2 Yrs
State Avg: 11.5 Yrs
Regional Practice Density
215 Specialists

Practicing in Vallejo, CA (14617 Statewide)

Telehealth Adoption Rate
3.7% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
76.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Nyquist (4 Years) 4 Yrs
Vallejo Specialty Average (4.2 Years) 4.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
123 123 $379.00 $89.83
99213 Established patient office or other outpatient visit, typically 15 minutes
123 110 $308.00 $74.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
102 85 $435.00 $103.51
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
93 93 $567.00 $136.29
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
31 31 $748.00 $166.73
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
26 21 $612.00 $147.34

Medical Specialties & State Licenses

CMS Verified: 2022-09-12
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License OR PA213297

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Providence Health And Services Oregon

940 Royal Ave, Medford, OR 975046194

Providence Health And Services Oregon

1698 E Mcandrews Rd, Medford, OR 975045590

Secondary Practice Locations

827 Spring St

Medford, OR 975046104

Phone: 5417327600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Carly Cole

Physician Assistant

NPI 1003633025
Andrea Kent

Student in an Organized Health Care Education/Training Program

NPI 1013621820
Ricardo Calixtro-Lopez

Physician Assistant

NPI 1013621853
Ashley Nicole Chan

Physician Assistant

NPI 1013735232
Emily Spain

Physician Assistant

NPI 1013882372
Austin Willis

Physician Assistant

NPI 1023682986

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
👤
Provider Name / Credentials Updated September 12, 2022

Recorded as GANNON NYQUIST, PA-C

NPI Profile Active May 14, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location May 14, 2021

Registered at 1310 CLUB DR, VALLEJO, CA 945921187 (Tel: 7076385809)

📍
Updated Business Mailing Address May 14, 2021

Registered at 624 N CASCADE AVE APT 41, COLORADO SPRINGS, CO 809033225 (Tel: 5052800158)

👤
Provider Name / Credentials Updated May 14, 2021

Recorded as GANNON NYQUIST

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2021

Physician Assistant

🟢
Initial NPI Registration & Enumeration May 14, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134793169
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 14, 2021
Last Update: September 12, 2022
Sole Proprietor: No

Mailing Address

624 N Cascade Ave Apt 41

Colorado Springs, CO 809033225

Phone: 5052800158

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.