Elizabeth J Riedel, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

77-PA007 Issued in NM

Practice address

1111 El Llano Rd
Espanola, NM 87532-6727

Phone

(505) 929-1629

Fax

(505) 753-5815

NPI assigned

Aug 31, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1780689034
  Medicare reassignment NPD
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1285899054
  NPD
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1437575289
  NPD (past)
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1457798712
  NPD (past)
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Wagon Mound, NM
  • NPI 1538324223
  NPD (past)
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1821373812
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1891788253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "address_2": "538 N. PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875320158",
            "telephone_number": "505-753-7218",
            "fax_number": "505-753-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 EL LLANO RD",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875326727",
            "telephone_number": "505-929-1629",
            "fax_number": "505-753-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDEL",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "77-PA007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NM400315",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92726",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael S Redman, D.M.D.
• Carey Michael Reed, APN
• Storm L Reilly
• Tanya P. Reyes, M.D.
• John L Rich, LPCC
• Rio Arriba County
• Rio Arriba County
• Rio Arriba County HHS
• Rio Arriba Health and Human Services
• Autumn Rios, LMFT

• Medical Physician Assistant in Espanola, NM
• Providers in Espanola, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.