Individual provider Active NPI

David J Ridley, M.D.

  • Rheumatology Physician
  • Eagan, MN
National Provider Identifier
1659396000
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
26149 Issued in MN
Practice address
2854 Highway 55 Ste 190
Eagan, MN 55121-1783
Phone
(651) 644-4277
Fax
(651) 644-4018
NPI assigned
Jul 13, 2006
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 26149 MN Primary

Addresses

Primary practice location

2854 Highway 55 Ste 190
Eagan, MN 55121-1783

Mailing address

2854 Highway 55 Ste 130
Eagan, MN 55121-1776
Phone (651) 224-4930

Other practice location 1

2680 Snelling Ave N Ste 120
Roseville, MN 55113-1877
Phone (651) 644-4277

Other identifiers 1

IdentifierTypeStateIssuer
585090800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100217000832 MN Practitioner - RheumatologyPractitioner - Internal Medicine 7618931429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
University of Minnesota Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Rheumatology P aGroup PAC ID 0941264741, 3 clinicians

Practice addresses (Care Compare)

2854 Hwy 55
Suite 190
Eagan, MN 55121-1783
Phone (651) 644-4277

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61.67 of 100Reported as group
Quality
71.67
Improvement activities
40
Cost
10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Rheumatology P a Rheumatology CurrentSince Feb 1, 2001 Accepting new patients
Alabaster Healthcare LLC PastSince Oct 30, 2022 Accepting new patients
Physicians Vein Clinics, PC Past Accepting new patients

Locations

2854 Highway 55
Ste 130
Saint Paul, MN 55121
Phone (651) 224-4930

2854 Highway 55
Ste 190
Saint Paul, MN 55121
Phone (612) 345-9900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFJHDD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1659396000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2854 HIGHWAY 55 STE 130",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211776",
            "telephone_number": "651-224-4930",
            "fax_number": "651-842-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2854 HIGHWAY 55 STE 190",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211783",
            "telephone_number": "651-644-4277",
            "fax_number": "651-644-4018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2680 Snelling Ave N Ste 120",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551131877",
            "country_code": "US",
            "telephone_number": "651-644-4277",
            "fax_number": "651-644-4018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDLEY",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "26149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "585090800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.