Jacob James Ridder, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in Omaha, Nebraska. He graduated from medical school in 2013 and has 11 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Advanced Dermatology Of The Midlands Pc, Advanced Dermatology Of The Midlands Pc and his current practice location is
12910 Pierce St Ste 120, Omaha, Nebraska. You can reach out to his office (for appointments etc.) via phone at
(402) 933-3770.
Jacob James Ridder is licensed to practice in Nebraska (license number 1768) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1508291717.
Physician's Profile
| Full Name | Jacob James Ridder |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 11 Years |
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| Location | 12910 Pierce St Ste 120, Omaha, Nebraska |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jacob James Ridder graduated from medical school in 2013
NPI Data:
- NPI Number: 1508291717
- Provider Enumeration Date: 09/06/2013
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 8820224603
- Enrollment ID: I20131127000358
Medical Identifiers
Medical identifiers for Jacob James Ridder such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508291717 | NPI | - | NPPES |
| 1841673738 | Medicaid | IA | |
| 10026411700 | Medicaid | NE | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 1768 (Nebraska) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 002439 (Iowa) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 1768 (Nebraska) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Advanced Dermatology Of The Midlands Pc | 5890926786 | 7 |
| Advanced Dermatology Of The Midlands Pc | 5890926786 | 7 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob James Ridder is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacob James Ridder, PA-C
12910 Pierce St Ste 120,
Omaha, NE 68144-1106
Ph: (402) 933-3770 | Jacob James Ridder, PA-C
12910 Pierce St Ste 120,
Omaha, NE 68144-1106
Ph: (402) 933-3770 |
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