Individual provider Active NPI

Alicia Riley, PA-C

  • Physician Assistant
  • New Albany, IN
National Provider Identifier
1255899456
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002496A Issued in IN
Practice address
2630 Grant Line Rd
New Albany, IN 47150-4053
Phone
(502) 888-1988
Fax
(812) 944-3594
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002496A IN Primary

Addresses

Primary practice location

2630 Grant Line Rd
New Albany, IN 47150-4053

Mailing address

PO Box 381468
Germantown, TN 38183-1468

Other identifiers 2

IdentifierTypeStateIssuer
7101055810MedicaidKY
300023952MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190319001799 IN Practitioner - Physician Assistant 8527308170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Health Partners PLLCGroup PAC ID 0840443636, 28 clinicians

Practice addresses (Care Compare)

2630 Grant Line Rd
New Albany, IN 47150-4053
Phone (812) 945-0145

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10002496AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology of Southern Indiana, P.C. Current Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alicia.riley.1@7598.direct.athenahealth.com

Organizations & group practices 3

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1255899456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 GRANT LINE RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504053",
            "telephone_number": "502-888-1988",
            "fax_number": "812-944-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "ALICIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002496A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101055810",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300023952",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.