David Robert Riedel, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036-060307 Issued in IL

Practice address

4 Memorial Dr Ste 230
Alton, IL 62002-6704

Phone

(618) 463-7874

Fax

(618) 463-7846

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment NPD
• Fairview Heights Medical Group SC

  dba BJC Medical Group of Illinois

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD
• Alton Memorial Hospital

  • General Practice Physician
  • Alton, IL
  • NPI 1801172903
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1073505004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 230",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-7874",
            "fax_number": "618-463-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 230",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-7874",
            "fax_number": "618-463-7846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 College Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620025008",
            "country_code": "US",
            "telephone_number": "618-462-3200",
            "fax_number": "618-463-5003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEDEL",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036-060307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4 Memorial Dr Ste 230",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ahmad Osama Rez, M.D
• Talyn Rhodes
• John Albert Richards Jr., M.D.
• Clint Ricker
• Brooke Lindsay Ridenbark, MSW,LSW
• Daniela V Riegel, DMD
• David Riesenberger, M.D.
• Katie Ringering
• Brenda Ringhausen
• Susanne Palladino Ringhausen, M.A.

• Gastroenterology Physician in Alton, IL
• Providers in Alton, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.