CARL ANTHONY RIDDICK (M.D.) – Pulmonary Disease Physician, NPI 1093751372

CARL ANTHONY RIDDICK (M.D.) is a healthcare provider. based in Sherwood, Oregon. specializing in Pulmonary Disease Physician. They hold the professional credentials M.D.. They hold a License No. MD20646 (OR). The NPI Number for CARL ANTHONY RIDDICK (M.D.) is 1093751372

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
CARL ANTHONY RIDDICK (M.D.)
NPI
1093751372
Phone
(503) 297-3778
Address
16770 SW Edy Rd Ste 216
Enumeration Date
22 June 2006
Last Update Date
23 November 2021

Doctor Profile

Medical School Name
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5032396673
Graduation Year
1984 (42 years ago)
PAC ID
8224060629
Group Practice PAC ID
2860390408
Professional Enrollment ID
I20090120000501

Contacts

Secure Messaging
referringplmw@orclinic.direct-ct.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

Provider Addresses for CARL ANTHONY RIDDICK (M.D.)

  • 16770 SW Edy Rd Ste 216

    Sherwood, OR 971409679

    Phone: (503) 297-3778

    Fax: (503) 297-7853

    Type: Location

  • 19250 SW 65th Ave Ste 135

    Tualatin, OR 970627745

    Phone: (503) 692-8560

    Fax: (503) 692-8562

    Type: Location

  • 879 Providence Dr

    Newberg, OR 971327563

    Phone: (503) 297-3778

    Fax: (503) 297-7853

    Type: Location

  • Cascadia Behavioral Healthcare Administrative Office, 847, Northeast 19th Avenue, Kerns, Portland, Metro, Multnomah County, Oregon, 97232, United States

    SUITE 300

    PORTLAND, OR 972322684

    Phone: (503) 963-2801

    Fax: (503) 963-2825

    Type: Mailing

  • Southwest Barnes Road, Sylvan-Highlands, Portland, Metro, Multnomah County, Oregon, 97210, United States

    PORTLAND, OR 972256667

    Phone: (503) 297-3778

    Fax: (503) 297-7853

    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: 2009-01-20

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
I20090120000501IPulmonary DiseaseORTBD

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 97140)

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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: 2860390408View full group profile
NameSpecialtyState
Pulmonary DiseaseOR
-OR
O T O L A R Y N G O L O G YOR
G A S T R O E N T E R O L O G YOR
Internal Medicine, GastroenterologyOR
Gastroenterology, Internal MedicineOR
G A S T R O E N T E R O L O G YOR
U R O L O G YOR
Physician AssistantOR
-OR

Reviews

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Frequently asked questions

What federal number belongs to CARL ANTHONY RIDDICK (M.D.)?
The federal identifier for CARL ANTHONY RIDDICK (M.D.) is NPI 1093751372.
Is CARL ANTHONY RIDDICK (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does CARL ANTHONY RIDDICK (M.D.) work in?
You can think of CARL ANTHONY RIDDICK (M.D.) as practicing within Pulmonary Disease Physician. Clinical services aligned with this taxonomy classification.
What location shows for CARL ANTHONY RIDDICK (M.D.)?
We surface Sherwood, Oregon for CARL ANTHONY RIDDICK (M.D.) based on available NPPES addresses.
How can I contact CARL ANTHONY RIDDICK (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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