Individual provider Active NPI

Samuel Riase Jr., DPM

  • Podiatrist
  • Tuscaloosa, AL
National Provider Identifier
1003929886
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
53 Issued in AL
Practice address
535 Jack Warner Pkwy NE
G-2
Tuscaloosa, AL 35404-5751
Phone
(205) 507-1264
Fax
(205) 507-1266
NPI assigned
Aug 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 53 AL Primary

Addresses

Primary practice location

535 Jack Warner Pkwy NE
G-2
Tuscaloosa, AL 35404-5751

Mailing address

535 Jack Warner Pkwy NE
G-2
Tuscaloosa, AL 35404-5751
Phone (205) 507-1264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050510000557 AL Practitioner - Podiatry 2860432705 Reassigns benefits to 1 organization
Practice locations: Tuscaloosa, AL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1101 Snows Mill Ave
Tuscaloosa, AL 35406-2015
Phone (205) 792-3743

Merit-based Incentive Payment System (MIPS)

Final score
75.77 of 100Reported as group
Quality
45.94
Promoting interoperability
85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
053ALMDSpecialist
53ALMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
360Care Services of Al LLC Podiatrist CurrentSince Jan 16, 2023 Accepting new patients
Specialty Medical Centers LLC Podiatrist CurrentSince Aug 1, 2005 Accepting new patients

Locations

4290 Highway 52 W
Ste D
Helena, AL 35080
Phone (205) 620-3340

150 S Perry St
Montgomery, AL 36104
Phone (225) 270-1012

11 Bell Rd
Selma, AL 36701
Phone (334) 874-7425

535 Jack Warner Pkwy NE
Ste G2
Tuscaloosa, AL 35404
Phone (205) 507-1264

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003929886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "G-2",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-507-1264",
            "fax_number": "205-507-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "G-2",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-507-1264",
            "fax_number": "205-507-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIASE",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AL",
            "license": "53",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.