Individual provider Active NPI

Erica Lynn Riedesel, MD

  • Pediatric Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1528004728
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
MD487304 Issued in PA
Practice address
3400 Spruce Street
Philadelphia, PA 19104-4206
Phone
(215) 662-3000
Fax
(215) 662-7011
NPI assigned
Jun 22, 2006
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X MD487304 PA Primary
Diagnostic Radiology Physician 2085R0202X MD487304 PA

Addresses

Primary practice location

3400 Spruce Street
Philadelphia, PA 19104-4206

Mailing address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 662-3000

Other practice location 1

1405 Clifton Rd NE
Atlanta, GA 30322-1060
Phone (404) 785-6541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA2 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
I20170921002505 GA Practitioner - Pediatric Medicine 8820212053 Reassigns benefits to 2 organizations
I20250226000052 PA Practitioner - Diagnostic Radiology 8820212053 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD487304PAMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc Pediatric Radiology CurrentSince Aug 16, 2017 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Shriners Hospitals for Children Diagnostic Radiology CurrentSince Mar 10, 2025 Accepting new patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Aug 16, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 1, 2025 Accepting new patients
Shriners Hospitals for Children CurrentSince Mar 10, 2025 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Aug 16, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 1, 2025 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

3551 N Broad St
Philadelphia, PA 19140
Phone (215) 430-4000

Organizations & group practices 10

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1528004728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-662-3000",
            "fax_number": "215-662-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3000",
            "fax_number": "215-662-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221060",
            "country_code": "US",
            "telephone_number": "404-785-6541",
            "fax_number": "404-785-1248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEDESEL",
        "first_name": "ERICA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "MD487304",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD487304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1405 Clifton Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303221060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.