Individual provider Active NPI

David Eric Ristedt, M.D.

  • Family Medicine Physician
  • Ithaca, NY
National Provider Identifier
1053483974
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
299640 Issued in NY
Practice address
1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone
(607) 257-5858
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 299640 NY Primary

Addresses

Primary practice location

1780 Hanshaw Rd
Ithaca, NY 14850-9105

Mailing address

1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone (607) 257-5858

Other practice location 1

54 Main St
Candor, NY 13743
Phone (607) 659-7272

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address dristedt145825@direct-guthrie.org Direct
Direct Messaging Address dristedt145825@direct-guthrie.org Direct
Direct Messaging Address dristedt145825@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20191024002872 NY Practitioner - Family Practice 6305178369 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

510 S 4TH St
Suite 2
Fulton, NY 13069-2952
Phone (315) 592-3510

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Emergency Physicians LLP CurrentSince Apr 16, 2023 Accepting new patients
Guthrie Medical Group, P.C. Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Port City Emergency Physicians LLP CurrentSince Apr 16, 2023 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Sep 1, 2019 Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

510 S 4th St
Ste 2
Fulton, NY 13069
Phone (315) 592-3510

1780 Hanshaw Rd
Ithaca, NY 14850
Phone (607) 257-5858

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

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 and National Provider Directory roles.

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1053483974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 HANSHAW RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509105",
            "telephone_number": "607-257-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 HANSHAW RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509105",
            "telephone_number": "607-257-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Main St",
            "address_purpose": "LOCATION",
            "city": "Candor",
            "state": "NY",
            "postal_code": "13743",
            "country_code": "US",
            "telephone_number": "607-659-7272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RISTEDT",
        "first_name": "DAVID",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "299640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dristedt145825@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1780 Hanshaw Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148509105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dristedt145825@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1780 Hanshaw Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148509105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dristedt145825@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1780 Hanshaw Rd",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148509105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.