Active NPI
Damon Jon Rideaux Jr., MD
- Anesthesiology Physician
- Miami, FL
National Provider Identifier
1407650666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 1111111
- Practice address
- 1611 NW 12TH Ave
Miami, FL 33136-1096 - Phone
- (305) 585-1111
- NPI assigned
- Apr 4, 2025
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 1111111 | NY | Primary |
Addresses
Primary practice location
1611 NW 12TH Ave
Miami, FL 33136-1096
Mailing address
414 E 65TH St Apt 2B
New York, NY 10065-7145
Phone (310) 502-8648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1111111 | NY | MD | Pediatric Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743724800000",
"number": "1407650666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 E 65TH ST APT 2B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100657145",
"telephone_number": "310-502-8648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361096",
"telephone_number": "305-585-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDEAUX",
"first_name": "DAMON",
"middle_name": "JON",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-04",
"last_updated": "2025-04-04",
"certification_date": "2025-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "1111111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.