Individual provider Active NPI

Dayna Ridderman, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1285959288
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11015385A Issued in IN
Practice address
901 Shelby St
Indianapolis, IN 46203-1151
Phone
(317) 957-2400
Fax
(317) 957-2420
NPI assigned
Apr 1, 2010
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11015385A IN Primary

Addresses

Primary practice location

901 Shelby St
Indianapolis, IN 46203-1151

Mailing address

3403 E Raymond St
Indianapolis, IN 46203-4744
Phone (317) 957-2000

Other identifiers 1

IdentifierTypeStateIssuer
201099100MedicaidIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131022000969 IN Practitioner - Family Practice 9931334224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Healthnet IncGroup PAC ID 7214840933, 77 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Healthnet Triage OB/GYN Services
Indianapolis, IN 46202-1239
Phone (317) 962-8909

2855 N Keystone Ave
Suite 120
Indianapolis, IN 46218-2790

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015385AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthnet, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1522 W Morris St
Indianapolis, IN 46221
Phone (317) 488-2020

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2340 E 10th St
Indianapolis, IN 46201
Phone (317) 633-7360

2855 N Keystone Ave
Ste 100
Indianapolis, IN 46218
Phone (317) 920-5760

2855 N Keystone Ave
Ste 130
Indianapolis, IN 46218

3401 E Raymond St
Indianapolis, IN 46203
Phone (317) 788-9769

3401 E Raymond St
#0
Indianapolis, IN 46203

3403 E Raymond St
Indianapolis, IN 46203
Phone (317) 957-2000

3908 Meadows Dr
Indianapolis, IN 46205
Phone (317) 579-2275

901 Shelby St
Indianapolis, IN 46203
Phone (317) 488-2040

6020 Crawfordsville Rd
Ste 102
Speedway, IN 46224
Phone (317) 957-2070

Interoperability endpoints

  • Direct secure messaging: dayna.ridderman@hn.eclinicaldirectplus.com

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

Hospital & facility affiliations 1

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": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1285959288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 E RAYMOND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462034744",
            "telephone_number": "317-957-2000",
            "fax_number": "317-957-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SHELBY ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462031151",
            "telephone_number": "317-957-2400",
            "fax_number": "317-957-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDERMAN",
        "first_name": "DAYNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11015385A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201099100",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.