NPIMap

Individual provider Active NPI

Craig A Riley, MD

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1184940827
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60485450 Issued in WA
Practice address
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone
(360) 514-2000
Fax
(360) 604-1767
NPI assigned
Apr 19, 2010
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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 MD160522 OR
Internal Medicine Physician 207R00000X MD60485450 WA Primary

Addresses

Primary practice location

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Other identifiers 2

IdentifierTypeStateIssuer
P01253251OtherORRR MEDICARE - PHS - 93-1097258
500626290MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address criley130068@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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
I20130702000752 OR Practitioner - Internal Medicine 5193965721 Reassigns benefits to 1 organization
I20141013002214 WA Practitioner - Internal Medicine 5193965721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

2529 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD160522ORMDInternal Medicine Physician
MD60485450WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Dec 1, 2014 Accepting new patients
Vibra Physicians LLC CurrentSince Mar 2, 2014 Accepting new patients
Columbia River Healthcare, Inc. Past Accepting new patients
Legacy Salmon Creek Hospital Past Accepting new patients
Fort Vancouver of Cascadia, LLC Past Accepting new patients
Beacon Hill Healthcare, Inc. Past Accepting new patients

Locations

10300 NE Hancock St
Portland, OR 97220
Phone (503) 257-5500

200 NE Mother Joseph Pl
Ste 420
Vancouver, WA 98664
Phone (360) 514-1234

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • Direct secure messaging: criley130068@oc.providencedirect.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beacon Hill RehabilitationLongview, WA, CCN 505294 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025
Jan 1, 2025
The Oaks at TimberlineVancouver, WA, CCN 505206 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Jun 1, 2021
Jun 1, 2021
Jul 8, 2025
Hudson Bay Health and RehabilitationVancouver, WA, CCN 505260 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2023
Feb 26, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1184940827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-514-2000",
            "fax_number": "360-604-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "CRAIG",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD160522",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60485450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE - PHS - 93-1097258",
            "identifier": "P01253251",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500626290",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "criley130068@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 540",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.