Jared Ridenour, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3021 Issued in OK

Practice address

6802 S Olympia Ave Ste 300
Tulsa, OK 74132-1826

Phone

(918) 749-0762

NPI assigned

Jan 17, 2019

Last updated

Jan 6, 2022By the provider in NPPES

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

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Tulsa Spine & Specialty Hospital Hospital, Tulsa, OK, CCN 370216
• Hillcrest Hospital Henryetta Hospital, Henryetta, OK, CCN 370183
• Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
• Direct secure messaging: jridenour556118@ahs.direct-ci.com

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.

• Ahs Oklahoma Physician Group LLC

  dba Utica Park Clinic

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Ahs Southcrest Hospital, LLC

  dba HIllcrest Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Henryetta Hospital LLC

  dba Hillcrest Hospital Henryetta

  • General Acute Care Hospital
  • Henryetta, OK
  • NPI 1720053556
  Care Compare affiliation
• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  dba HIllcrest Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation
• Bailey Medical Center, LLC

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1205846037
  Care Compare affiliation
• Tulsa Spine & Specialty Hospital

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1033185293
  Care Compare affiliation

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1619441177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321826",
            "telephone_number": "918-749-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321826",
            "telephone_number": "918-749-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDENOUR",
        "first_name": "JARED",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Riddle
• Matthew Robert Riddle
• Ride by Your Side
• Chelsea Ridener, DNP
• Keevie Chinsethagid Ridener, PHARM. D
• Karol Kay Rideout, M.S.,CCC-SLP
• Lacey Jean Rider Lemmons
• Sydnie Rider
• Wendy Rider
• Christina Paige Ridgway

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.

Verify at the official NPI Registry.