NPIMap

Individual provider Active NPI

Rodney Tyson Riedel, MD

  • Family Medicine Physician
  • Maple Valley, WA
National Provider Identifier
1366426405
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00042699 Issued in WA
Practice address
26458 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038-8350
Phone
(425) 656-5577
Fax
(425) 656-5595
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD00042699 WA
Family Medicine Physician 207Q00000X MD00042699 WA Primary

Addresses

Primary practice location

26458 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038-8350

Mailing address

PO Box 34876
Renton, WA 98055
Phone (425) 656-5412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150917001081 WA Practitioner - Family PracticePractitioner - Sports Medicine 4587694021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
New York Medical College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

26458 Maple Valley Black Diamond Rd
Maple Valley, WA 98038-8350
Phone (425) 656-5577

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00042699WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients
Deleo Family Medicine P C Family Medicine Past Accepting new patients
Catskill Regional Medical Center Family Medicine Past Accepting new patients
Ulster Family Medicine, LLP Family Medicine Past Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

26458 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038
Phone (425) 656-5577

3600 Lind Ave SW
Ste 100
Renton, WA 98057

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3549/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rreidel56183@direct.valleymed.org

Organizations & group practices 6

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 3

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1366426405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98055",
            "telephone_number": "425-656-5412",
            "fax_number": "425-656-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26458 MAPLE VALLEY BLACK DIAMOND RD SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980388350",
            "telephone_number": "425-656-5577",
            "fax_number": "425-656-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDEL",
        "first_name": "RODNEY",
        "middle_name": "TYSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD00042699",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

Verify at the official NPI Registry.