NPIMap

Individual provider Active NPI

David Ridder, M.D.

  • Trauma Surgery Physician
  • Lake Havasu City, AZ
National Provider Identifier
1154778207
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
25544 Issued in NV
Practice address
1851 Mesquite Ave Ste 210
Lake Havasu City, AZ 86403-5681
Phone
(928) 854-7540
Fax
(928) 885-4240
NPI assigned
May 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25544 NV
Surgery Physician 208600000X 74218 AZ
Surgical Critical Care Physician 2086S0102X 25544 NV
Surgical Critical Care Physician 2086S0102X 74218 AZ
Trauma Surgery Physician 2086S0127X 74218 AZ
Trauma Surgery Physician 2086S0127X 25544 NV Primary

Addresses

Primary practice location

1851 Mesquite Ave Ste 210
Lake Havasu City, AZ 86403-5681

Mailing address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone (702) 653-2273

Other practice location 1

1800 W Charleston Blvd
Las Vegas, NV 89102-2386
Phone (702) 383-2000

Other practice location 2

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240926002985 AZ Practitioner - General SurgeryPractitioner - Other (Physician) 0345514147 Reassigns benefits to 2 organizations
I20250203001234 NV Practitioner - General Surgery 0345514147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HRMC, LLCGroup PAC ID 3072641265, 33 clinicians
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

101 Civic Ctr LN
Lake Havasu City, AZ 86403-5607
Phone (928) 453-3761

1707 W Charleston Blvd
Suite 160
Las Vegas, NV 89102-2354
Phone (702) 671-5150

Hospital & facility affiliations

  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
  • University Medical Center Hospital, Las Vegas, NV, CCN 290007
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055
  • Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74218AZMDSurgery Physician
25544NVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bullhead City Clinic Corp CurrentSince Aug 4, 2024 Accepting new patients
HRMC, LLC CurrentSince Jul 15, 2024 Accepting new patients
Unlv Medicine CurrentSince Jan 9, 2025 Accepting new patients
HRMC, LLC Current Accepting new patients
Unlv Medicine CurrentSince Jan 9, 2025 Accepting new patients
Bullhead City Clinic Corp Surgery CurrentSince Aug 4, 2024 Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
HRMC, LLC Past Accepting new patients

Locations

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1851 Mesquite Ave
Ste 210
Lk Havasu Cty, AZ 86403
Phone (928) 854-7540

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

1707 W Charleston Blvd
Ste 160
Las Vegas, NV 89102
Phone (702) 671-2201

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4
  • Direct secure messaging: david.ridder.1@19231.direct.athenahealth.com

Organizations & group practices 8

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1154778207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 MESQUITE AVE STE 210",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035681",
            "telephone_number": "928-854-7540",
            "fax_number": "928-885-4240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022386",
            "country_code": "US",
            "telephone_number": "702-383-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "25544",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "74218",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NV",
            "license": "25544",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "AZ",
            "license": "74218",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "AZ",
            "license": "74218",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NV",
            "license": "25544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.