Individual provider Active NPI

Daniel J Riordan, D.O.

  • Internal Medicine Physician
  • Muskego, WI
National Provider Identifier
1174545891
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
49311 Issued in WI
Practice address
S69W15636 Janesville Rd
Muskego, WI 53150-9330
Phone
(262) 928-7000
Fax
(414) 422-2079
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 49311 WI Primary

Addresses

Primary practice location

S69W15636 Janesville Rd
Muskego, WI 53150-9330

Mailing address

S69W15636 Janesville Rd
Muskego, WI 53150-9330
Phone (262) 928-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20060901000228 WI Practitioner - Internal Medicine 3173527272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

S69W15472 Janesville Rd
Muskego, WI 53150-9330
Phone (262) 928-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36647SCMDPharmacist
49311WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. Internal Medicine CurrentSince Dec 1, 2015 Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients

Locations

2750 Golf Rd
Delafield, WI 53018
Phone (262) 928-4900

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

837 Highway NN E
Mukwonago, WI 53149
Phone (262) 363-6830

S69W15636 Janesville Rd
Muskego, WI 53150
Phone (262) 513-7000

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: driordan15446@direct.phci.org

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.

Hospital & facility affiliations 2

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1174545891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S69W15636 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531509330",
            "telephone_number": "262-928-7000",
            "fax_number": "414-422-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S69W15636 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531509330",
            "telephone_number": "262-928-7000",
            "fax_number": "414-422-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIORDAN",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "49311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskego, WI

Sources for this page

Verify at the official NPI Registry.