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JAMES MCILHENNY RIDDLEBERGER M.D.
NPI 1114308277
Family Medicine in Portland, ME

Active since June 15, 2015PECOS Enrolled
331 VERANDA ST, PORTLAND, ME 04103(207) 828-2402(207) 828-2425 Get Directions Write a Review

NPPES record last updated: October 1, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 1, 2020, Aug 14, 2018 (2 updates tracked since 2018).

About James Mcilhenny Riddleberger M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES MCILHENNY RIDDLEBERGER M.D. (NPI 1114308277) is an individual family medicine provider in Portland, Maine, licensed in Maine (MD22299) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Northern Light Health, and is a graduate of Tulane University School Of Medicine (2015).

NPPES Registry Identity

NPI1114308277
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES MCILHENNY RIDDLEBERGERCredential: M.D.
Location Address331 VERANDA STPortland, ME 04103
Mailing AddressPo Box 9746Portland, ME 04104-5040 · (207) 791-3888 · Fax (207) 828-7850
Phone(207) 828-2402
Fax(207) 828-2425
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 2015
Enumeration DateJune 15, 2015
Last NPPES UpdateOctober 1, 20202 updates tracked since enumeration
NPPES CertifiedOctober 1, 2020
✔ NPI 1114308277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ME · MD22299
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
331 VERANDA ST, Portland, ME 04103
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Taro Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James Mcilhenny Riddleberger M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951618511
PECOS Enrollment IDI20180803000734
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show James Riddleberger reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Martin's Point Health Care, Inc.
0.1 mi
Family Medicine
331 VERANDA ST
Portland, ME 04104
  • Reassigned Medicare billing, Maine enrollment
  • 153 clinicians in this Medicare group
NPI 1366474611 (207) 791-3888
Mainehealth
1.9 mi
Family Medicine
272 CONGRESS ST
Portland, ME 04101
  • Reassigned Medicare billing, Maine enrollment
  • 3,140 clinicians in this Medicare group
NPI 1639194509 (207) 874-2466
Maine Medical Partners
5.2 mi
Family Medicine
1 HARNOIS AVE
Westbrook, ME 04092
  • Reassigned Medicare billing, Maine enrollment
  • 206 clinicians in this Medicare group
NPI 1790896876 (207) 662-3400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
83 services48 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
77 services56 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
43 services37 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
42 services36 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
41 services41 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
38 services36 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northern Light Health

Acute Care Hospitals · Portland, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number200008
Location144 State StreetPortland, ME 04101 · Cumberland County
Emergency services Birthing friendly

Maine Medical Center

Acute Care Hospitals · Portland, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200009
Location22 Bramhall StPortland, ME 04102 · Cumberland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%361 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
9%111 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%128 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
47%412 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
98%412 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
51%412 patients3/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
53%412 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
1 supplier11 claims88 services$2.27 avg. paid by Medicare
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6216
DME-Medical/Surgical Supplies · category DA023N
1 supplier11 claims660 services$0.04 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDA K MORRISON MD
Ophthalmology
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
MR. DAVID GHIORSE PA-C
Physician Assistant
331 VERANDA ST, MARTINS POINT HEALTH CARE
PORTLAND, ME 04103
Cumberland County (207) 828-2402
CARLEEN KNIGHT NP
Nurse Practitioner
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
JOSHUA GELFAND DPT
Physical Therapist
331 VERANDA ST, BUILDING 6, ROOM 3311
PORTLAND, ME 04103
Cumberland County (207) 536-0702
GEORGE NICHOLAS WELCH MD
Internal Medicine (Cardiovascular Disease)
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
DR. DOUGLAS COUPER MD
Internal Medicine
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 791-3796
DR. WILLIAM R WADLAND MD
Family Medicine (Geriatric Medicine)
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
DR. WILLIAM SCHIRMER MD
Family Medicine
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 791-3782

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Riddleberger's NPI number?

The NPI number for James Riddleberger is 1114308277. It was assigned to this individual provider in the NPPES registry on June 15, 2015.

Where is James Riddleberger located?

James Riddleberger practices at 331 Veranda St, Portland, ME 04103. The listed phone number is (207) 828-2402.

What is James Riddleberger's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is James Riddleberger enrolled in Medicare?

Yes. James Riddleberger is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for James Riddleberger's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Riddleberger reassigns Medicare benefits to 3 organizations: Martin's Point Health Care, Inc. (Portland, ME), Mainehealth (Portland, ME) and Maine Medical Partners (Westbrook, ME). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Riddleberger's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Riddleberger accept?

Health plans from Anthem Blue Cross and Blue Shield and Taro Health list James Riddleberger as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is James Riddleberger affiliated with any hospitals?

According to CMS data, James Riddleberger is affiliated with Northern Light Health and Maine Medical Center.

When was this NPI record last updated?

The NPPES record for James Riddleberger was last updated on October 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.