Philip Jabee Riddle Jr, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Providence, Rhode Island. His current practice location is
164 Summit Ave, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at
(401) 793-2500.
Philip Jabee Riddle Jr is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1598324337.
Physician's Profile
| Full Name | Philip Jabee Riddle Jr |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 164 Summit Ave, Providence, Rhode Island |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1598324337
- Provider Enumeration Date: 06/06/2019
- Last Update Date: 07/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 9830421825
- Enrollment ID: I20220516002117
Medical Identifiers
Medical identifiers for Philip Jabee Riddle Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1598324337 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | 82730 (South Carolina) | Secondary |
| 207RC0200X | Internal Medicine - Critical Care Medicine | LP06227 (Rhode Island) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Philip Jabee Riddle Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Philip Jabee Riddle Jr, MD 164 Summit Ave Ste 221, Providence, RI 02906-2853 Ph: () - | Philip Jabee Riddle Jr, MD 164 Summit Ave, Providence, RI 02906-2853 Ph: (401) 793-2500 |
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