Individual provider Active NPI

Emily Justusson Riddle, MD

  • Neurology Physician
  • Portland, OR
National Provider Identifier
1457767584
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD195374 Issued in OR
Practice address
3303 SW Bond Ave
Portland, OR 97239-4501
Phone
(503) 494-7772
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD195374 OR Primary

Addresses

Primary practice location

3303 SW Bond Ave
Portland, OR 97239-4501

Mailing address

743 SW Maplecrest CT
Portland, OR 97219-6407
Phone (845) 242-6856

Other practice location 1

740 S Limestone St
L-441 Kentucky Clinic
Lexington, KY 40536-0001
Phone (859) 323-5661

Other practice location 2

3333 Burnet Ave
Location E, Floor4, MLC 2015
Cincinnati, OH 45229
Phone (513) 636-4222

Other names 1

  • Emily Ann Meloche Justusson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190208002916 KY Practitioner - Neurology 1355568999 Reassigns benefits to 1 organization
I20191209000623 OR Practitioner - Neurology 1355568999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Oregon Health Sciences University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD195374ORMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
Kentucky Medical Services Foundation, Inc Neurology CurrentSince Dec 14, 2018 Accepting new patients
University Professional Services CurrentSince Dec 9, 2019 Accepting new patients
University Professional Services CurrentSince Dec 9, 2019 Accepting new patients
University Professional Services Past Accepting new patients
University of Kentucky Past Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

Interoperability endpoints

  • Direct secure messaging: eriddle12118@direct.ohsu.edu

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 1

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": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1457767584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 SW MAPLECREST CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972196407",
            "telephone_number": "845-242-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-7772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Limestone St",
            "address_2": "L-441 Kentucky Clinic",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-5661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Burnet Ave",
            "address_2": "Location E, Floor4, MLC 2015",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45229",
            "country_code": "US",
            "telephone_number": "513-636-4222",
            "fax_number": "513-636-3980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "EMILY",
        "middle_name": "JUSTUSSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD195374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "JUSTUSSON",
            "middle_name": "ANN MELOCHE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.