Individual provider Active NPI

Douglas Graham Ridyard, M.D.

  • Urology Physician
  • Farmington, CT
National Provider Identifier
1639532872
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
21352 Issued in NH
Practice address
263 Farmington Ave
Farmington, CT 06030-8073
Phone
(860) 679-3438
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 21352 NH Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-8073

Mailing address

263 Farmington Ave
Farmington, CT 06030-8073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210721003829 NH Practitioner - Urology 1557655537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Boston University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

4 Elliot Way
Suite 200
Manchester, NH 03103-3553
Phone (603) 836-1590

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.1 of 100Reported as group
Quality
84.36
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21352NHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manchester Urology Associates Professional Association Urology CurrentSince Sep 1, 2021 Accepting new patients
Manchester Urology Associates Professional Association Urology CurrentSince Sep 1, 2021 Accepting new patients
Elliot Professional Services CurrentSince Dec 15, 2025 Accepting new patients

Locations

14 Tsienneto Rd
Derry, NH 03038
Phone (603) 425-6966

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

4 Elliot Way
Ste 200
Manchester, NH 03103
Phone (603) 669-9200

17 Riverside St
Nashua, NH 03062
Phone (603) 577-3190

Interoperability endpoints

  • Direct secure messaging: douglas.ridyard@xdr.hhchealthdirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1639532872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308073",
            "telephone_number": "860-679-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDYARD",
        "first_name": "DOUGLAS",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NH",
            "license": "21352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.