JENTRY DANIELLE RIDDLE (PA) – Medical Physician Assistant, NPI 1003849837
Medical Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JENTRY DANIELLE RIDDLE (PA)
1201, Sam Bass Road, Old Round Rock, Round Rock, Williamson County, Texas, 78681, United States
ROUND ROCK, TX 786814137
Phone: (512) 388-1861
Fax: (512) 388-0373
Type: Mailing
4204 EAST STAN SCHLEUTER LOOP
KILLEEN, TX 765428352
Phone: (254) 690-2800
Fax: (254) 690-5401
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 128 Open Payments records for all available years, with a total value of $2,084.
Total Amount is formed as General ($2,084) + Research ($0) + Ownership ($0) = $2,084.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($646).
Total Amount
$2,084
General + Research + Ownership
Payments
128
Total payment records
General Amount
$2,084
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $646 |
| Mylan Specialty L.P. | $521 |
| AstraZeneca Pharmaceuticals LP | $382 |
| Regeneron Healthcare Solutions, Inc. | $169 |
| GENZYME CORPORATION | $88 |
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: 2008-08-18
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 |
|---|---|---|---|---|
| I20080818000072 | I | Physician Assistant | TX | 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 78681)
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