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JACOB JAMES RIDDER PA-C NPI 1508291717


NPI Information

NPI: 1508291717
Provider Name: JACOB JAMES RIDDER, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
12910 PIERCE ST STE 120
OMAHA, NE
ZIP 68144
Phone: (402) 933-3770
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Jacob James Ridder, PA-C is a medical physician assistant in Omaha, NE with 11 years of experience. Jacob James Ridder, PA-C NPI is 1508291717. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12910 PIERCE ST STE 120
OMAHA, NE
ZIP 68144-106
Phone: (402) 933-3770
Fax: (402) 933-3633

The NPI 1508291717 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Destruction of skin growth (HCPCS:17000)
  • Tangential biopsy of single skin lesion (HCPCS:11102)
  • Destruction of up to 14 skin growths (HCPCS:17110)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Tangential biopsy of additional skin lesion (HCPCS:11103)

The enumeration date for this NPI number is 9/6/2013 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatology1768NEBRASKANo
2363AM0700XPhysician AssistantMedical002439IOWANo
3363AM0700XPhysician AssistantMedical1768NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110026411700MEDICAIDNEBRASKA
21841673738MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.