Individual provider Active NPI

John Ribadeneyra, M.D.

  • Family Medicine Physician
  • Montrose, CO
National Provider Identifier
1689897753
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR0057738 Issued in CO
Practice address
1804 E Pavilion PL Unit a
Montrose, CO 81401-5795
Phone
(970) 249-6670
Fax
(970) 252-1372
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA09410400 NJ
Family Medicine Physician 207Q00000X DR0057738 CO Primary

Addresses

Primary practice location

1804 E Pavilion PL Unit a
Montrose, CO 81401-5795

Mailing address

1804 E Pavilion PL Unit a
Montrose, CO 81401-5795
Phone (786) 351-3093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20170602000410 CO Practitioner - Family Practice 5890012017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Slope Family Medicine, PLLCGroup PAC ID 7517234164, 2 clinicians

Practice addresses (Care Compare)

1804 E Pavilion PL
Montrose, CO 81401-5795
Phone (970) 249-6670

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0057738COMDFamily Medicine Physician
25MA09410400NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Slope Family Medicine, PLLC Family Medicine CurrentSince May 11, 2017 Accepting new patients

Locations

1804 E Pavilion Pl
Unit A
Montrose, CO 81401
Phone (970) 249-6670

1804 E Pavilion Pl
Montrose, CO 81401
Phone (970) 249-6670

Interoperability endpoints

  • Direct secure messaging: john.ribadeneyra.1@18696.direct.athenahealth.com

Organizations & group practices 1

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 6

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1689897753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 E PAVILION PL UNIT A",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015795",
            "telephone_number": "786-351-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 E PAVILION PL UNIT A",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015795",
            "telephone_number": "970-249-6670",
            "fax_number": "970-252-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBADENEYRA",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09410400",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR0057738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.