NPIMap

Organization Active NPI

Riddle Medical LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Haworth, NJ
National Provider Identifier
1245286640
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MA177617 Issued in NJ
Legal business name
RIDDLE MEDICAL LLC
Practice address
401 Sylvan PL
Haworth, NJ 07641-1729
Phone
(201) 618-1818
NPI assigned
May 26, 2006
Last updated
Nov 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Authorized official

Name
Dr. Albert Riddle, MDNPI 1699724880
Title
Owner
Phone
(201) 618-1818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MA177617 NJ Primary

Addresses

Primary practice location

401 Sylvan PL
Haworth, NJ 07641-1729

Mailing address

PO Box 29
Haworth, NJ 07641-0029
Phone (201) 512-9494

Other identifiers 1

IdentifierTypeStateIssuer
02752096MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091030000340 NY Part B Supplier - Clinic/Group Practice 7113937103 Receives reassigned benefits from 7 practitioners
Practice locations: Montgomery, NY; Rome, NY; Poughkeepsie, NY; Ossining, NY; New Rochelle, NY; Lake Katrine, NY; Kingston, NY; Highland, NY…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1245286640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076410029",
            "telephone_number": "201-512-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SYLVAN PL",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076411729",
            "telephone_number": "201-618-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDDLE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-618-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MA177617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02752096",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haworth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.