NPIMap

Organization Active NPI

Jeffrey R. Ridha M.D. P.C.

  • Medical Specialty Clinic/Center
  • Saratoga Springs, NY
National Provider Identifier
1639442742
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
229760 Issued in NY
Legal business name
JEFFREY R. RIDHA M.D. P.C.
Practice address
72 Railroad PL
Saratoga Springs, NY 12866-3008
Phone
(518) 306-5466
Fax
(518) 306-5470
NPI assigned
Feb 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Authorized official

Name
Dr. Jeffrey R Ridha, M.D.NPI 1396927737
Title
Owner
Phone
(518) 306-5466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 229760 NY Primary

Addresses

Primary practice location

72 Railroad PL
Saratoga Springs, NY 12866-3008

Mailing address

72 Railroad PL
Saratoga Springs, NY 12866-3008
Phone (518) 306-5466

Other identifiers 1

IdentifierTypeStateIssuer
J100072789OtherNYMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

72 Railroad Pl
Saratoga Springs, NY 12866
Phone (518) 306-5466

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1639442742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 RAILROAD PL",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128663008",
            "telephone_number": "518-306-5466",
            "fax_number": "518-306-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 RAILROAD PL",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128663008",
            "telephone_number": "518-306-5466",
            "fax_number": "518-306-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY R. RIDHA M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "RIDHA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-306-5466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "229760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J100072789",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.