Riley D Waldeck, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT8820 Issued in ID

Practice address

3157 E Barber Valley Dr Ste 120
Boise, ID 83716-4770

Phone

(208) 901-8477

Fax

(208) 629-7529

NPI assigned

Jul 27, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wright Physical Therapy Limited PartnershipGroup PAC ID 1759612641, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wright Physical Therapy Limited Partnership

  • Physical Therapist
  • Twin Falls, ID
  • NPI 1730732025
  Medicare reassignment Care Compare group NPD
• Wright Physical Therapy Limited Partnership

  • Physical Therapist
  • Logan, UT
  • NPI 1770317455
  NPD

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1861173247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 401",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-901-8477",
            "fax_number": "208-629-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3157 E BARBER VALLEY DR STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837164770",
            "telephone_number": "208-901-8477",
            "fax_number": "208-629-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDECK",
        "first_name": "RILEY",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT8820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores, Inc
• Laura Elizabeth Walawender, M.D.
• Christina Marie Wald, LMSW
• David A Wald, MD
• Debbie Wald, PT
• Jeremy David Waldram, M.D.
• Joni S Waldram, PHARMD
• Theresa Walelu
• Walgreen Co
• Walgreen Co

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.