Active NPI
Brant Ridder
- Physician Assistant
- Fremont, NE
National Provider Identifier
1295469336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3044
- Practice address
- 410 E 22ND St Ste 1
Fremont, NE 68025-2640 - Phone
- (402) 719-7152
- NPI assigned
- Jul 14, 2022
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3044 | NE | Primary |
Addresses
Primary practice location
410 E 22ND St Ste 1
Fremont, NE 68025-2640
Mailing address
410 E 22ND St Ste 1
Fremont, NE 68025-2640
Phone (402) 727-7979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE, IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Edmundson PL
Suite 200
Council Bluffs, IA 51503-4658
Phone (402) 390-4111
1408 Veterans Dr
Suite 100
Elkhorn, NE 68022-6912
Phone (402) 916-5665
8005 Farnam Dr
Suite 305
Omaha, NE 68114-3426
Phone (402) 390-4111
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3044 | NE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skin PC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dermatology Physician
- Elkhorn, NE
- NPI 1134410764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761782400000",
"number": "1295469336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 E 22ND ST STE 1",
"city": "FREMONT",
"state": "NE",
"postal_code": "680252640",
"telephone_number": "402-727-7979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 E 22ND ST STE 1",
"city": "FREMONT",
"state": "NE",
"postal_code": "680252640",
"telephone_number": "402-719-7152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDER",
"first_name": "BRANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-14",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "3044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.