Individual provider Active NPI

James Matthew Ridgway, M.D.

  • Otolaryngology Physician
  • Bellevue, WA
National Provider Identifier
1023265261
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A95785 Issued in CA
Practice address
1231 116TH Ave NE Ste 900
Bellevue, WA 98004-3822
Phone
(425) 365-4970
Fax
(425) 365-4969
NPI assigned
Aug 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A95785 CA Primary

Addresses

Primary practice location

1231 116TH Ave NE Ste 900
Bellevue, WA 98004-3822

Mailing address

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-5853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090812000921 WA Practitioner - Otolaryngology 6204980089 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A95785CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud 9 Surgery Center CurrentSince Dec 9, 2019 Accepting new patients

Locations

1231 116th Ave NE
Ste 900
Bellevue, WA 98004
Phone (425) 365-4970

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1023265261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5853",
            "fax_number": "714-456-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE STE 900",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043822",
            "telephone_number": "425-365-4970",
            "fax_number": "425-365-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGWAY",
        "first_name": "JAMES",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A95785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.