Stephen Ralph Ribaudo, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

01034333 Issued in IN

Practice address

229 Red Coach Dr
Suite 102
Mishawaka, IN 46545-3195

Phone

(574) 252-5852

Fax

(574) 252-5862

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Stephen Ralph Ribaudo Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physical Medicine and Rehabilitation

Education

Other, 1980

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephenribaudo@143392.advancedmd-direct.com

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.

• Stephen Ralph Ribaudo PC

  • Physical Medicine & Rehabilitation Physician
  • Mishawaka, IN
  • NPI 1346443520
  NPD Authorized official

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1730281841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 RED COACH DR",
            "address_2": "SUITE 102",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453195",
            "telephone_number": "574-252-5852",
            "fax_number": "574-252-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 RED COACH DR",
            "address_2": "SUITE 102",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453195",
            "telephone_number": "574-252-5852",
            "fax_number": "574-252-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBAUDO",
        "first_name": "STEPHEN",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01034333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "250000701",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100090100A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephenribaudo@143392.advancedmd-direct.com",
            "affiliation": "N",
            "address_1": "229 Red Coach Dr",
            "address_2": "Suite 102",
            "city": "Mishawaka",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465453195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHEN",
            "last_name": "RIBAUDO",
            "middle_name": "RALPH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephanie Reynolds, MSW
• Thomas K Rhee, MD
• Kirstin P Rhinehart, OD
• Sarah R Rhodes, MS, LAT, ATC
• Troy Rhodes, O.D.
• Jacquelyn Marie Rice, HIS, LPN
• Jonathan Rich
• Bradley A Richards, MD
• Emily Richardson, RBT
• Hannah Richendollar, RBT

• Physical Medicine & Rehabilitation Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Physical Medicine & Rehabilitation Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.