Dustin David Riddle, DC,DPM,MHA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1127-25 Issued in WI

Practice address

W2654 County Road KK
Appleton, WI 54915-9468

Phone

(920) 830-2221

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Falls Clinic LLCGroup PAC ID 8325944499, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Great Falls Clinic Hospital Hospital, Great Falls, MT, CCN 270086
• Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012

Merit-based Incentive Payment System (MIPS)

Final score

90.98 of 100Reported as apm

Quality

80.39

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dustin.riddle.1@25095.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/25095/brand/1/csg/1/fhir/r4

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.

• Great Falls Clinic LLC

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1801897780
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Benefis Hospitals Inc

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • Air Ambulance
  • Great Falls, MT
  • NPI 1114934023

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1881650737
  Care Compare affiliation
• CMSC, LLC

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1639109978
  Care Compare affiliation

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1972617629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2654 COUNTY ROAD KK",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549159468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W2654 COUNTY ROAD KK",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549159468",
            "telephone_number": "920-830-2221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575640",
            "country_code": "US",
            "telephone_number": "414-687-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "DUSTIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC,DPM,MHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3880-012",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "1127-25",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135000875",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38961800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard J. Schoengarth DDS SC
• Heather A Richardson
• Lindsey Richmond, OT
• Daniel W Richter, D.C.
• Kristina Rickert
• Patricia M Riedl, APNP
• Janessa Riehl, RN
• Chandler Riem
• Olivia Mae Riemer, AU.D.
• Amy J Rietz, AUD

• Foot & Ankle Surgery Podiatrist in Appleton, WI
• Providers in Appleton, WI by specialty
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.

Verify at the official NPI Registry.