Active NPI
Michael T Ricciardi, DO
- Psychiatry Physician
- Coronado, CA
National Provider Identifier
1205840618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20A6018
- Practice address
- 1224 Tenth St
# 200
Coronado, CA 92118 - Phone
- (619) 435-6902
- Fax
- (619) 435-6996
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20A6018 | CA | Primary |
Addresses
Primary practice location
1224 Tenth St
# 200
Coronado, CA 92118
Mailing address
1224 Tenth St
# 200
Coronado, CA 92118
Phone (619) 435-6902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A6018 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1205840618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 TENTH ST",
"address_2": "# 200",
"city": "CORONADO",
"state": "CA",
"postal_code": "92118",
"telephone_number": "619-435-6902",
"fax_number": "619-435-6996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 TENTH ST",
"address_2": "# 200",
"city": "CORONADO",
"state": "CA",
"postal_code": "92118",
"telephone_number": "619-435-6902",
"fax_number": "619-435-6996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICCIARDI",
"first_name": "MICHAEL",
"middle_name": "T",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A6018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coronado, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.