Individual provider Active NPI

Catherine D Riley, MD

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1346770369
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
94-09278 Issued in KS
Practice address
4560 Lake Ridge Pkwy Ste 200
Grand Prairie, TX 75052-1706
Phone
(972) 263-5272
Fax
(972) 263-3488
NPI assigned
Jun 13, 2017
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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 94-09278 KS Primary

Addresses

Primary practice location

4560 Lake Ridge Pkwy Ste 200
Grand Prairie, TX 75052-1706

Mailing address

4560 Lake Ridge Pkwy Ste 200
Grand Prairie, TX 75052-1706
Phone (972) 263-5272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201015001179 TX Practitioner - Family Practice 9335410679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

4560 Lake Ridge Pkwy
Suite 200
Grand Prairie, TX 75052-1706
Phone (972) 263-5272

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-09278KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Oct 19, 2020 Accepting new patients
Medhealth Family Medicine Current Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

4560 Lake Ridge Pkwy
Ste 200
Grand Prairie, TX 75052
Phone (972) 263-5272

Interoperability endpoints

  • Direct secure messaging: criley132058@dm.mhd.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 4

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1346770369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 LAKE RIDGE PKWY STE 200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521706",
            "telephone_number": "972-263-5272",
            "fax_number": "972-263-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 LAKE RIDGE PKWY STE 200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521706",
            "telephone_number": "972-263-5272",
            "fax_number": "972-263-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "CATHERINE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-09278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.