Active NPI
Elijah Wade Riddle, M.D.
- Surgery Physician
- Wynnewood, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD454180
- Practice address
- 100 E Lancaster Ave
Suite 275 Lankenau Med Sci BLDG
Wynnewood, PA 19096-3450 - Phone
- (610) 642-1908
- Fax
- (610) 642-6808
- NPI assigned
- May 21, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD454180 | PA | Primary |
| Pediatric Surgery Physician | 2086S0120X | MD454180 | PA |
Addresses
Primary practice location
100 E Lancaster Ave
Suite 275 Lankenau Med Sci BLDG
Wynnewood, PA 19096-3450
Mailing address
3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Other practice location 1
735 Norman Dr Ste 3
Lebanon, PA 17042-7559
Phone (717) 270-7908
Other practice location 2
3401 Civic Center Blvd
Division of Surgery
Philadelphia, PA 19104-4319
Phone (215) 662-6156
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Washington University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (610) 642-1908
Hospital & facility affiliations
- Main Line Health Home Care & Hospice - Home Health
- Main Line Hospital Lankenau
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD454180 | PA | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspan Medical Group | Pediatric Surgery | Current | Accepting new patients |
| University Physician Associates of New Jersey Inc | Current | Accepting new patients | |
| Wellspan Medical Group | Current | Accepting new patients | |
| University Physician Associates of New Jersey Inc | Surgery | Current | Accepting new patients |
| Main Line Healthcare | Surgery | Current | Accepting new patients |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Wellspan Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Surgery | Current | Accepting new patients |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Main Line Hospitals, Inc. | Past | Accepting new patients | |
| University Hospital | Past | Accepting new patients |
Locations
30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037
30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037
830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200
735 Norman Dr
Ste 3
Lebanon, PA 17042
Phone (717) 270-7908
3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530
3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669
100 E Lancaster Ave
Ste 275
Wynnewood, PA 19096
Phone (484) 476-8390
100 E Lancaster Ave
#275
Wynnewood, PA 19096
Phone (215) 622-3743
25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250
Organizations & group practices 11
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.
-
- Gynecologic Oncology Physician
- Philadelphia, PA
- NPI 1235527342
-
- Gastroenterology Physician
- York, PA
- NPI 1669770004
-
- Surgery Physician
- Newark, NJ
- NPI 1639189236
-
- Surgery Physician
- Philadelphia, PA
- NPI 1275921298
-
- Surgical Oncology Physician
- Philadelphia, PA
- NPI 1871981985
-
- Pediatric Surgery Physician
- York, PA
- NPI 1104799428
-
- Family Medicine Physician
- York, PA
- NPI 1457044794
-
- Internal Medicine Physician
- Newark, NJ
- NPI 1760492367
-
- General Acute Care Hospital
- Wynnewood, PA
- NPI 1245335629
-
- General Acute Care Hospital
- Newark, NJ
- NPI 1215998323
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wynnewood, PA
- NPI 1245335629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763596800000",
"number": "1609136993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3803 W CHESTER PIKE STE 160",
"city": "NEWTOWN SQUARE",
"state": "PA",
"postal_code": "190732336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E LANCASTER AVE",
"address_2": "SUITE 275 LANKENAU MED SCI BLDG",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "610-642-1908",
"fax_number": "610-642-6808"
}
],
"practiceLocations": [
{
"address_1": "735 Norman Dr Ste 3",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "PA",
"postal_code": "170427559",
"country_code": "US",
"telephone_number": "717-270-7908",
"fax_number": "717-272-1734",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3401 Civic Center Blvd",
"address_2": "Division of Surgery",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191044319",
"country_code": "US",
"telephone_number": "215-662-6156",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIDDLE",
"first_name": "ELIJAH",
"middle_name": "WADE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-21",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD454180",
"primary": true
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "PA",
"license": "MD454180",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wynnewood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.