Individual provider Active NPI

Anna Elizabeth Riddle, PA-C

  • Physician Assistant
  • Mt Pleasant, PA
National Provider Identifier
1053087171
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA064102 Issued in PA
Practice address
116 Magnolia Dr
Mount Pleasant, PA 15666-2482
Phone
(724) 771-5030
NPI assigned
Aug 18, 2021
Last updated
Oct 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X MA064102 PA Primary

Addresses

Primary practice location

116 Magnolia Dr
Mount Pleasant, PA 15666-2482

Mailing address

116 Magnolia Dr
Mount Pleasant, PA 15666-2482
Phone (724) 771-5030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20221125000084 PA Practitioner - Physician Assistant 1254709108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1086 Franklin St
Johnstown, PA 15905-4305

1086 Franklin St E
Johnstown, PA 15905-4305
Phone (814) 534-9104

1086 Franklin St M
Johnstown, PA 15905-4305
Phone (814) 534-9194

1111 Franklin St
Johnstown, PA 15905-4341

415 Napoleon PL
Johnstown, PA 15901-2504
Phone (814) 539-8725

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Single Specialty CurrentSince Dec 1, 2022 Accepting new patients
Conemaugh Health Initiatives Single Specialty Past Accepting new patients
Windber Hospital, Inc. Single Specialty Past Accepting new patients

Locations

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

415 Napoleon Pl
Johnstown, PA 15901
Phone (814) 529-8725

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: ariddle47110@direct.conemaugh.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1053087171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MAGNOLIA DR",
            "city": "MOUNT PLEASANT",
            "state": "PA",
            "postal_code": "156662482",
            "telephone_number": "724-771-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MAGNOLIA DR",
            "city": "MOUNT PLEASANT",
            "state": "PA",
            "postal_code": "156662482",
            "telephone_number": "724-771-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "ANNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, PA

Sources for this page

Verify at the official NPI Registry.