Carissa Rittberg, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2388 Issued in TN

Practice address

559 Medical Squadron
221 Third Street W BLDG 1040
Universal City, TX 78150

Phone

(210) 916-9900

NPI assigned

Jun 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1700172723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 MEDICAL SQUADRON",
            "address_2": "221 THIRD STREET W BLDG 1040",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "78150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 MEDICAL SQUADRON",
            "address_2": "221 THIRD STREET W BLDG 1040",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "78150",
            "telephone_number": "210-916-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3278 Mitchell Blvd",
            "address_purpose": "LOCATION",
            "city": "Moody AFB",
            "state": "GA",
            "postal_code": "316995109",
            "country_code": "US",
            "telephone_number": "229-257-3165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "511 N Torch Blvd Bldg 300",
            "address_2": "27 SOSS/OSM",
            "address_purpose": "LOCATION",
            "city": "Cannon AFB",
            "state": "NM",
            "postal_code": "881035109",
            "country_code": "US",
            "telephone_number": "575-784-1103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RITTBERG",
        "first_name": "CARISSA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "2388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.tricareonline.com/tol2/prelogin",
            "affiliation": "N",
            "endpointDescription": "Tricare online portal",
            "address_1": "3278 Mitchell Blvd",
            "city": "Moody AFB",
            "state": "GA",
            "country_code": "US",
            "postal_code": "316995109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• General Practice Physician in Universal City, TX
• Providers in Universal City, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.