CARL ANTHONY RIDDICK (M.D.) – Pulmonary Disease Physician, NPI 1093751372
Pulmonary Disease Physician
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Profile Insights
NPPES metrics only — not quality of care.
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090120000501 | I | Pulmonary Disease | OR | TBD |
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.
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
- 1
- 2
- 3
- 4
- 5
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | OR | |
| - | OR | |
| O T O L A R Y N G O L O G Y | OR | |
| G A S T R O E N T E R O L O G Y | OR | |
| Internal Medicine, Gastroenterology | OR | |
| Gastroenterology, Internal Medicine | OR | |
| G A S T R O E N T E R O L O G Y | OR | |
| U R O L O G Y | OR | |
| Physician Assistant | OR | |
| - | OR |
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