NPIMap

Individual provider Active NPI

Patrick William Riley, PA-C, ATC

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1790765253
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
407 E 3Rd St
Eh St Mary's Medical Center
Duluth, MN 55805-1950
Phone
(218) 786-4626
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1525 MN
Physician Assistant 363A00000X MN Primary
Physician Assistant 363A00000X 3855-23 WI

Addresses

Primary practice location

407 E 3Rd St
Eh St Mary's Medical Center
Duluth, MN 55805-1950

Mailing address

400 E 3Rd St
Essentia Health Duluth Clinic McL2Cred
Duluth, MN 55805-1951
Phone (218) 786-1183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160816002560 WI Practitioner - Physician Assistant 1557656444 Reassigns benefits to 2 organizations
I20160817001052 MN Practitioner - Physician Assistant 1557656444 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians

Practice addresses (Care Compare)

1301 Miller Trunk Hwy
Suite 400
Duluth, MN 55811-5639
Phone (218) 576-0680

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1525MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic LTD CurrentSince Aug 19, 2019 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 19, 2019 Accepting new patients
St. Mary's Medical Center CurrentSince Sep 19, 2016 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Sep 19, 2016 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Sep 19, 2016 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Duluth Graduate Medical Education Council Inc Past Accepting new patients

Locations

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1790765253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "address_2": "EH ST MARY'S MEDICAL CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "PATRICK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1525",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3855-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.