NPIMap

Individual provider Active NPI

Andrew John Ridder, M.D.

  • Neurology Physician
  • Sioux Falls, SD
National Provider Identifier
1285993253
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
10894 Issued in SD
Practice address
1301 S Cliff Ave Ste 506
Sioux Falls, SD 57105
Phone
(605) 335-0844
Fax
(605) 335-3951
NPI assigned
May 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301102371 MI
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X 10894 SD Primary

Addresses

Primary practice location

1301 S Cliff Ave Ste 506
Sioux Falls, SD 57105

Mailing address

1301 S Cliff Ave Ste 506
Sioux Falls, SD 57105-1023
Phone (605) 335-0844

Other practice location 1

4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 764-6831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180711003857 SD Practitioner - Neurology 3971809963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Sanford School of Medicine of University of South Dakota, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1301 S Cliff Ave
Suite 610
Sioux Falls, SD 57105-1032
Phone (605) 322-8860

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301102371MIMDNeurology Physician
10894SDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 9, 2018 Accepting new patients
Avera McKennan CurrentSince Jul 9, 2018 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1301 S Cliff Ave
Ste 610
Sioux Falls, SD 57105
Phone (605) 322-8860

1301 S Cliff Ave
Ste 506
Sioux Falls, SD 57105
Phone (605) 335-0844

Interoperability endpoints

  • Direct secure messaging: andrew.ridder@avera.sdhealthlink.net

Organizations & group practices 5

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 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1285993253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE STE 506",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051023",
            "telephone_number": "605-335-0844",
            "fax_number": "605-335-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE STE 506",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57105",
            "telephone_number": "605-335-0844",
            "fax_number": "605-335-3951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4260 Plymouth Rd",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481092700",
            "country_code": "US",
            "telephone_number": "734-764-6831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDER",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-11",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301102371",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SD",
            "license": "10894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.