JOHN RILEY (PA-C) – Physician Assistant, NPI 1376008250

JOHN RILEY (PA-C) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 58656 (CA). The NPI Number for JOHN RILEY (PA-C) is 1376008250

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
JOHN RILEY (PA-C)
NPI
1376008250
Phone
(616) 455-5000
Address
300 68TH ST SE
Enumeration Date
5 February 2019
Last Update Date
10 July 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Secondary Phone
2486252970
Graduation Year
2018 (8 years ago)
PAC ID
9234470857
Group Practice PAC ID
3577099787
Professional Enrollment ID
I20190409001629
Address ID
MI483462377CL5980XSTXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:7State licenses:2Digital endpointsOther names

6,112 PHYSICIAN ASSISTANT in MI

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Provider Addresses for JOHN RILEY (PA-C)

  • Pine Rest Christian Mental Health Services, 300, 68th Street Southeast, Grand Rapids, Gaines Township, Kent County, Michigan, 49501, United States

    GRAND RAPIDS, MI 495486927

    Phone: (616) 455-5000

    Type: Location

  • 900 W UNIVERSITY DR STE A-2

    ROCHESTER, MI 483071817

    Phone: (248) 266-0920

    Fax: (248) 266-0898

    Type: Mailing

  • 619 PARKWOOD ST NE

    GRAND RAPIDS, MI 495033413

    Phone: (248) 719-2079

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $122.

Total Amount is formed as General ($122) + Research ($0) + Ownership ($0) = $122.

Last reported payment date: 2023-03-02 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($122).

Total Amount

$122

General + Research + Ownership

Payments

1

Total payment records

General Amount

$122

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-02

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-01-26

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190409001629IPhysician AssistantMITBD
I20210126000302IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49548)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577099787View full group profile
NameSpecialtyState
Addiction Medicine, PsychiatryCA

Reviews

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Frequently asked questions

What identifier follows JOHN RILEY (PA-C) across health systems?
The NPI 1376008250 uniquely identifies JOHN RILEY (PA-C) in U.S. healthcare data.
Quick check: is JOHN RILEY (PA-C) active?
Public NPPES data shows JOHN RILEY (PA-C) with an active NPI status right now.
Which specialty label fits JOHN RILEY (PA-C)?
NPPES ties JOHN RILEY (PA-C) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is JOHN RILEY (PA-C) tied to Grand Rapids, Michigan?
If you are local to Grand Rapids, Michigan, JOHN RILEY (PA-C) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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