Individual provider Active NPI

Anthony Allen Richa, D.O.

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1801174073
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101019599 Issued in MI
Practice address
11885 E 12 Mile Rd
Ste. 300 a
Warren, MI 48093-3474
Phone
(586) 582-6630
Fax
(586) 582-6631
NPI assigned
Jul 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101019599 MI Primary

Addresses

Primary practice location

11885 E 12 Mile Rd
Ste. 300 a
Warren, MI 48093-3474

Mailing address

11885 E 12 Mile Rd
Ste. 300 a
Warren, MI 48093-3474
Phone (586) 582-6630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160421001380 FL Practitioner - Emergency Medicine 7416255609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101019599MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists of Jacksonville CurrentSince Feb 18, 2016 Accepting new patients
Emergency Physicians Inc CurrentSince Jun 15, 2018 Accepting new patients
Emergency Physicians Inc CurrentSince Jun 15, 2018 Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

Organizations & group practices 3

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": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1801174073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD",
            "address_2": "STE. 300 A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933474",
            "telephone_number": "586-582-6630",
            "fax_number": "586-582-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD",
            "address_2": "STE. 300 A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933474",
            "telephone_number": "586-582-6630",
            "fax_number": "586-582-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHA",
        "first_name": "ANTHONY",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.