Robert Mason Ricketts Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

D0039296 Issued in MD

Practice address

1011 Baltimore Blvd
Suite E
Westminster, MD 21157-7055

Phone

(410) 469-5001

NPI assigned

Oct 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Merit-based Incentive Payment System (MIPS)

Final score

83.23 of 100Reported as group

Quality

60.26

Promoting interoperability

100

Improvement activities

40

Cost

76.75

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

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.

• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment NPD
• Robert M. Ricketts, MD, PA

  • Specialist
  • Westminster, MD
  • NPI 1295768851
  NPD (past) Authorized official
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Westminster, MD
  • NPI 1225428915
  NPD
• Midatlantic Cardiovascular Associates PA

  • Cardiovascular Disease Physician
  • Baltimore, MD
  • NPI 1821084112
  NPD (past)

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1699954602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BALTIMORE BLVD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211577055",
            "telephone_number": "410-469-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BALTIMORE BLVD",
            "address_2": "SUITE E",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211577055",
            "telephone_number": "410-469-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "ROBERT",
        "middle_name": "MASON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0039296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066921102",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly S. Rhoton, LCSW-C
• Brian D Ricci
• Melissa Josanne Richards, FNP
• Susan Richardson, LCSW-C
• Alexandra Rickeman, LCMFT
• Neal Ridgeway
• Benjamin Adam Ridlon, PTA
• Crystal Riley, PA-C
• Raymond Z Riley, PA-C
• Elizabeth Suzanne Rinehart, M.S., CCC-SLP

• Specialist in Westminster, MD
• Providers in Westminster, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.