Leonard V Ridilla, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA05731800 Issued in PA

Practice address

15 E Redman Ave
Haddonfield, NJ 08033-2316

Phone

(856) 428-1335

Fax

(856) 428-6334

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2019 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: l.ridilla@hfpp-nj.direct.office.nextgen.com
• Direct secure messaging: lridilla89480@direct.cooperhealth.edu

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.

• Kennedy Medical Group Practice, P.C.

  dba Jefferson Health

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1568468692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E REDMAN AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332316",
            "telephone_number": "856-428-1335",
            "fax_number": "856-428-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E REDMAN AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332316",
            "telephone_number": "856-428-1335",
            "fax_number": "856-428-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDILLA",
        "first_name": "LEONARD",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MA05731800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Charles 'Chad' Renshaw, LPC
• Richard E Kwasnik
• Richard J Pressman
• Richard W Romash
• Jamie Ricker, ATC
• Jacqueline Riedel, DO
• Rite Aid of New Jersey Inc (Rite Aid Pharmacy 00837)
• Donald James Riviello, D.M,D.
• Robert B Hill M.D. Facs Inc
• Kenneth John Rogers, PHD, ATC

• Family Medicine Physician in Haddonfield, NJ
• Providers in Haddonfield, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.