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DR. MARK RIEDY MD NPI 1780681445


NPI Information

NPI: 1780681445
Provider Name: DR. MARK RIEDY, MD
Classification: Internal Medicine - 207RC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

PECOS Registration: Yes

Address:
2845 GREENBRIER RD
SUITE 210
GREEN BAY, WI
ZIP 54311
Phone: (920) 288-8100
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DR. Mark Riedy, MD is a critical care medicine internal medicine in Green Bay, WI with 30 years of experience. The provider is an internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. DR. Mark Riedy, MD NPI is 1780681445. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduation Year:1994

The provider's business location address is:

2845 GREENBRIER RD
SUITE 210
GREEN BAY, WI
ZIP 54311-519
Phone: (920) 288-8100

The NPI 1780681445 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 enumeration date for this NPI number is 7/7/2005 and was last updated on 12/3/2021.


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
1207RC0200XInternal MedicineCritical Care Medicine22748SOUTH CAROLINANo
2207RC0200XInternal MedicineCritical Care Medicine54662WISCONSINYes

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
18902914MEDICAIDNORTH CAROLINA
2CM7718OTHERRAILROAD MEDICARE
3227481MEDICAIDSOUTH CAROLINA
4GP1062MEDICAIDSOUTH CAROLINA
502914OTHERNORTH CAROLINABCBS
6GP3912OTHERSOUTH CAROLINAMEDICAID GROUP
7GP4306OTHERSOUTH CAROLINAMEDICAID GROUP
8H503647762OTHERSOUTH CAROLINAH503647762

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.