Individual provider Active NPI

Maribeth Riday, RN, MSN, RDH

  • Psychiatric/Mental Health Nurse Practitioner
  • Watsonville, CA
National Provider Identifier
1720241474
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
18870 Issued in CA
Practice address
1430 Freedom Blvd Ste B
Watsonville, CA 95076-2780
Phone
(831) 763-8200
Fax
(831) 454-4663
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 697504 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 18870 CA Primary

Addresses

Primary practice location

1430 Freedom Blvd Ste B
Watsonville, CA 95076-2780

Mailing address

1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4170

Other identifiers 6

IdentifierTypeStateIssuer
ZZZ91891ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP PTAN#
2012001567OtherCAANCC B CERTIFICATION#
ZZZ92069ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP PTAN#
18870OtherCANURSE PRACTITIONER FURNISHING LICENSE
ZZZ91892ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP PTAN#
FHC40044FOtherCASANTA CRUZ COUNTY MEDICAID GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150428001442 CA Practitioner - Nurse Practitioner 0143549014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa CruzGroup PAC ID 7618872912, 65 clinicians

Practice addresses (Care Compare)

1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
697504CAMDRegistered Nurse
18870CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Cruz CurrentSince Mar 9, 2015 Accepting new patients
County of Santa Cruz Past Accepting new patients
South County Mental Health Past Accepting new patients
County of Santa Cruz Past Accepting new patients
Puentes Al Sur Past Accepting new patients

Locations

1400 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4900

1080 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4100

1430 Freedom Blvd
Ste D
Watsonville, CA 95076
Phone (831) 763-8400

1430 Freedom Blvd
Watsonville, CA 95076
Phone (831) 763-8200

1430 Freedom Blvd
Ste B
Watsonville, CA 95076
Phone (831) 359-5653

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1720241474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4170",
            "fax_number": "831-454-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD STE B",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762780",
            "telephone_number": "831-763-8200",
            "fax_number": "831-454-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDAY",
        "first_name": "MARIBETH",
        "credential": "RN, MSN, RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "697504",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "18870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91891Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC B CERTIFICATION#",
            "identifier": "2012001567",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER FURNISHING LICENSE",
            "identifier": "18870",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICAID GROUP NUMBER",
            "identifier": "FHC40044F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.