Active NPI
Laresa Ridge, M.D.
- Family Medicine Physician
- Houston, TX
National Provider Identifier
1831120310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- L7535
- Practice address
- 9105 N Wayside Dr
Houston, TX 77028-1030 - Phone
- (214) 276-8665
- NPI assigned
- Jul 5, 2006
- Last updated
- Nov 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | L7535 | TX | Primary |
Addresses
Primary practice location
9105 N Wayside Dr
Houston, TX 77028-1030
Mailing address
17330 Lassen Forest LN
Humble, TX 77346-1550
Phone (281) 788-2615
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168810301 | Medicaid | TX | |
| 8P2795 | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Texas Medical School at Houston, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2525 Holly Hall St
Houston, TX 77054-4124
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573430400000",
"number": "1831120310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17330 LASSEN FOREST LN",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773461550",
"telephone_number": "281-788-2615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9105 N WAYSIDE DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770281030",
"telephone_number": "214-276-8665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDGE",
"first_name": "LARESA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2019-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "L7535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "168810301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8P2795",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.