NPIMap

Individual provider Active NPI

Peter James Ridella, MD

  • Orthopaedic Surgery Physician
  • Johnstown, PA
National Provider Identifier
1124015797
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD018887E Issued in PA
Practice address
1111 Franklin St
Suite 140
Johnstown, PA 15905-4330
Phone
(814) 535-5554
Fax
(814) 535-5255
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD018887E PA Primary
Orthopaedic Hand Surgery Physician 207XS0106X MD018887E PA
Orthopaedic Surgery of the Spine Physician 207XS0117X MD018887E PA
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X MD018887E PA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD018887E PA
Orthopaedic Trauma Physician 207XX0801X MD018887E PA

Addresses

Primary practice location

1111 Franklin St
Suite 140
Johnstown, PA 15905-4330

Mailing address

1111 Franklin St
Suite 140
Johnstown, PA 15905-4330
Phone (814) 535-5554

Other identifiers 1

IdentifierTypeStateIssuer
0007978670002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD018887EPAMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1124015797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 FRANKLIN ST",
            "address_2": "SUITE 140",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-535-5554",
            "fax_number": "814-535-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 FRANKLIN ST",
            "address_2": "SUITE 140",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-535-5554",
            "fax_number": "814-535-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDELLA",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD018887E",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "PA",
            "license": "MD018887E",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "PA",
            "license": "MD018887E",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "PA",
            "license": "MD018887E",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "PA",
            "license": "MD018887E",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "PA",
            "license": "MD018887E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007978670002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.