LUCY RIDEOUT (FNP) – Family Nurse Practitioner, NPI 1073053351

LUCY RIDEOUT (FNP) is a healthcare provider. based in Portland, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 201605242RN (OR). The NPI Number for LUCY RIDEOUT (FNP) is 1073053351

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
LUCY RIDEOUT (FNP)
NPI
1073053351
Phone
(888) 227-3312
Address
4816 NW BETHANY BLVD
Enumeration Date
6 March 2017
Last Update Date
15 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9713000654
Graduation Year
2020 (6 years ago)
PAC ID
4587021480
Group Practice PAC ID
7517354517
Professional Enrollment ID
I20230608001217
Address ID
OR972238074PO13535AVEX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:9State licenses:2Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

Provider Addresses for LUCY RIDEOUT (FNP)

  • 4816 NW BETHANY BLVD

    PORTLAND, OR 972299254

    Phone: (888) 227-3312

    Fax: (971) 282-0100

    Type: Location

  • PO BOX 2928

    PORTLAND, OR 972082928

    Phone: (425) 207-5155

    Type: Mailing

  • 10330 SE 32nd Ave

    110

    Milwaukie, OR 972226587

    Phone: (347) 721-8101

    Type: Location

  • 4400 NE Halsey St Ste 200

    Portland, OR 972131545

    Phone: (503) 215-6556

    Type: Location

  • Andrew C. DeWeese, 4531, Southeast Belmont Street, Hawthorne, Sunnyside, Portland, Metro, Multnomah County, Oregon, 97215, United States

    100

    PORTLAND, OR 972151675

    Phone: (347) 721-8101

    Type: Mailing

  • 10330, Southeast 32nd Avenue, Ardenwald-Johnson Creek, Milwaukie, Metro, Clackamas County, Oregon, 97222, United States

    110

    MILWAUKIE, OR 972226587

    Phone: (347) 721-8101

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-06-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20230608001217INurse PractitionerORTBD

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 97229)

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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: 7517354517View full group profile
NameSpecialtyState
Nurse PractitionerOR
Nurse PractitionerOR
Nurse PractitionerUT
Nurse PractitionerOR
Physician AssistantOR
Nurse PractitionerOR
Physician AssistantOR
Physician AssistantWA
Nurse PractitionerWA
Physician AssistantOR

Reviews

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Frequently asked questions

Can I use this page to confirm LUCY RIDEOUT (FNP)'s NPI?
Yes. LUCY RIDEOUT (FNP) is listed with NPI 1073053351 in the public NPI dataset.
Does CMS list LUCY RIDEOUT (FNP) as active?
Yes — LUCY RIDEOUT (FNP) is active in the NPI listing used on this page.
What is LUCY RIDEOUT (FNP) best known for clinically?
Directory data describes LUCY RIDEOUT (FNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does LUCY RIDEOUT (FNP) serve?
LUCY RIDEOUT (FNP)'s listing highlights Portland, Oregon; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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