Tricia A Riddle, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11017304 Issued in FL

Practice address

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Phone

(866) 849-0692

NPI assigned

Feb 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Tricia Ann Russell Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tricia.riddle.1@29601.direct.athenahealth.com

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

• Conviva Medical Center Management LLC

  dba Conviva Care Center

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278
  Medicare reassignment NPD
• Metcare of Florida, Inc

  dba Conviva Care Center

  • Internal Medicine Physician
  • Hialeah, FL
  • NPI 1902893225
  Medicare reassignment NPD
• Health Care Services LC

  • Family Medicine Physician
  • Stuart, FL
  • NPI 1447290259
  Medicare reassignment
• Metcare of Florida, Inc

  dba Conviva Care Center

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1619433869
  NPD

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1013660794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349845108",
            "telephone_number": "772-871-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 SE Port St Lucie Blvd",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349845108",
            "country_code": "US",
            "telephone_number": "772-871-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "TRICIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1212806",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "31432",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP034908",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11017304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "RUSSELL",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shannon Ginell Richards, APRN FNP-BC
• Laurie Richardson, ARNP
• Sander Richiez
• Percival George Ricketts, ED.D, LMHC
• Laura Elizabeth Rico, RN
• Ride Well Transit LLC
• Kimberly Warren Riesgo, PA-C
• Elizabeth Rincon, M.D.
• Jennifer R Riordan Jaquith, LCSW
• Krysten Riordan, PA

• Nurse Practitioner in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.