RIDAA IDRISS PA-C
NPI 1396201315
Student in an Organized Health Care Education/Training Program in Bronx, NY

Active since February 14, 2019PECOS EnrolledAccepts Medicare Assignment
111 E 210TH ST, BRONX, NY 10467(718) 920-4800 Get Directions Write a Review

NPPES record last updated: July 24, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 24, 2019, Feb 14, 2019 (2 updates tracked since 2019).

About Ridaa Idriss Pa-c NPPES

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

RIDAA IDRISS PA-C (NPI 1396201315) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS, is affiliated with St Francis Hospital - The Heart Center, and maintains a secondary practice location in Bronx.

NPPES Registry Identity

NPI1396201315
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameRIDAA IDRISSCredential: PA-C
Location Address111 E 210TH STBronx, NY 10467
Mailing Address111 E 210th StBronx, NY 10467-2401 · (718) 920-4800
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateFebruary 14, 2019
Last NPPES UpdateJuly 24, 20192 updates tracked since enumeration
NPI 1396201315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
111 E 210TH ST, Bronx, NY 10467

Secondary Practice Location 1

Location 135 Marcy Pl Apt 3CBronx, NY 10452-7336 · Phone (914) 565-4644

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ridaa Idriss Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567872963
PECOS Enrollment IDI20201112002629
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.

Areas of Expertise CMS Part B claims

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.

Removal of blood clot and portion of chest, neck, or brain artery 35301
This procedure involves the removal of a blood clot and a section of an artery in the chest, neck, or brain. It is often necessary to restore normal blood flow, prevent stroke, or alleviate symptoms related to the clot. The procedure is carried out by a skilled medical team.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

St Francis Hospital - The Heart Center

Acute Care Hospitals · Roslyn, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number330182
Location100 Port Washington BoulevardRoslyn, NY 11576 · Nassau County
Emergency services

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.

Pediatrics (Pediatric Cardiology)
111 E 210TH ST, MONTEFIORE MEDICAL CENTER
BRONX, NY 10467
Pediatrics (Adolescent Medicine)
111 E 210TH ST, DEPARTMENT OF PEDIATRICS
BRONX, NY 10467
Internal Medicine (Infectious Disease)
111 E 210TH ST
BRONX, NY 10467
Radiology (Diagnostic Neuroimaging)
111 E 210TH ST
BRONX, NY 10467
Psychiatry & Neurology (Neurology)
111 E 210TH ST
BRONX, NY 10467
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Nurse Practitioner (Family)
111 E 210TH ST
BRONX, NY 10467
Anesthesiology
111 E 210TH ST
BRONX, NY 10467

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 Ridaa Idriss's NPI number?

The NPI number for Ridaa Idriss is 1396201315. It was assigned to this individual provider in the NPPES registry on February 14, 2019.

Where is Ridaa Idriss located?

Ridaa Idriss practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (718) 920-4800.

What is Ridaa Idriss's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ridaa Idriss enrolled in Medicare?

Yes. Ridaa Idriss is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Ridaa Idriss affiliated with any hospitals?

According to CMS data, Ridaa Idriss is affiliated with St Francis Hospital - The Heart Center.

When was this NPI record last updated?

The NPPES record for Ridaa Idriss was last updated on July 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.