NPIMap

Individual provider Active NPI

Kristen M Riegert, MD

  • Radiation Oncology Physician
  • Walla Walla, WA
National Provider Identifier
1164658209
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD60444423 Issued in WA
Practice address
401 W Poplar St
Walla Walla, WA 99362
Phone
(509) 897-5700
Fax
(509) 897-5705
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL18588 OR
Radiation Oncology Physician 2085R0001X MD60444423 WA Primary

Addresses

Primary practice location

401 W Poplar St
Walla Walla, WA 99362

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

5050 NE Hoyt St
Suite 540
Portland, OR 97213-2991
Phone (503) 215-6600

Other names 1

  • Kristen M O'Donnell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CO2 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
I20140703001279 WA Practitioner - Radiation Oncology 6608091707 Reassigns benefits to 1 organization
I20240801003494 CO Practitioner - Radiation Oncology 6608091707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Oregon Health Sciences University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

750 Wellington Ave
Grand Junction, CO 81501-6132

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Montrose Regional Health Hospital, Montrose, CO, CCN 060006
  • Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL18588ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Internal Medicine Current Accepting new patients
Providence Health & Services - Washington Radiation Oncology CurrentSince Aug 1, 2014 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Jul 22, 2022 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Internal Medicine CurrentSince Jul 22, 2022 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Internal Medicine Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

750 Wellington Ave
Grand Junction, CO 81501
Phone (970) 244-2457

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Organizations & group practices 7

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 7

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1164658209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-897-5700",
            "fax_number": "509-897-5705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 NE Hoyt St",
            "address_2": "Suite 540",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132991",
            "country_code": "US",
            "telephone_number": "503-215-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEGERT",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "LL18588",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD60444423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "O'DONNELL",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.