Active NPI
Phillip Patrick Rideout, MD
- Vascular Surgery Physician
- Gainesville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 73048
- Practice address
- 200 S Enota Dr NE Ste 360
Gainesville, GA 30501-3466 - Phone
- (770) 219-4000
- NPI assigned
- Jun 11, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 6088 | GA | |
| Vascular Surgery Physician | 2086S0129X | 73048 | GA | Primary |
Addresses
Primary practice location
200 S Enota Dr NE Ste 360
Gainesville, GA 30501-3466
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
1924 Alcoa Hwy # U-11
Knoxville, TN 37920
Phone (865) 305-9006
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | prideout106383@nghs.gadirect.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Medical University of South Carolina College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
200 S Enota Dr NE
Suite 360
Gainesville, GA 30501-3466
Phone (770) 219-4000
Hospital & facility affiliations
- Northeast Georgia Medical Center, Inc
- Northeast Georgia Medical Center Habersham
- Northeast Georgia Medical Center Lumpkin
- NGMC Barrow, LLC
- Northside Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.83 of 100
- Quality
- 80.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.08
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
| Varicose vein removal | 12 |
| Leg revascularization (restoring blood flow) | 29 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73048 | GA | MD | Vascular Surgery Physician |
| 6088 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Georgia Physicians Group Inc | Surgery | Current | Accepting new patients |
| Northeast Georgia Medical Center, Inc. | Past | Accepting new patients |
Locations
1404 River Pl
#201
Braselton, GA 30517
Phone (770) 219-9200
597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275
200 S Enota Dr NE
Ste 360
Gainesville, GA 30501
Phone (770) 219-4000
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.
-
- Family Medicine Physician
- Gainesville, GA
- NPI 1891745212
Surgery
-
- General Acute Care Hospital
- Gainesville, GA
- NPI 1427055821
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winder, GA
- NPI 1881144889
-
- General Acute Care Hospital
- Dahlonega, GA
- NPI 1083174973
-
- General Acute Care Hospital
- Demorest, GA
- NPI 1740981430
-
- General Acute Care Hospital
- Gainesville, GA
- NPI 1427055821
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1457396079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1093153116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742616",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303742616",
"telephone_number": "770-219-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S ENOTA DR NE STE 360",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013466",
"telephone_number": "770-219-4000"
}
],
"practiceLocations": [
{
"address_1": "1924 Alcoa Hwy # U-11",
"address_purpose": "LOCATION",
"city": "Knoxville",
"state": "TN",
"postal_code": "37920",
"country_code": "US",
"telephone_number": "865-305-9006",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIDEOUT",
"first_name": "PHILLIP",
"middle_name": "PATRICK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-11",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "6088",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "GA",
"license": "73048",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "prideout106383@nghs.gadirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "200 S Enota Dr NE Ste 360",
"city": "Gainesville",
"state": "GA",
"country_code": "US",
"postal_code": "305013466",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.
- 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.