JONATHAN RIDENOUR, PA
NPI 1699233403
Psychologist in Tyler, TX
About Jonathan Ridenour, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JONATHAN RIDENOUR, PA (NPI 1699233403) is a healthcare organization registered as a psychologist in Tyler, Texas and active in the NPI registry since March 2019. The organization lists Michelle Bice, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jonathan Ridenour, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jonathan Ridenour, PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jonathan Ridenour, PA's NPI number?
The NPI number for Jonathan Ridenour, PA is 1699233403. It was assigned to this organization in the NPPES registry on March 11, 2019.
Where is Jonathan Ridenour, PA located?
Jonathan Ridenour, PA is located at 4801 Troup Hwy Ste 502, Tyler, TX 75703. The listed phone number is (972) 424-9212.
What is Jonathan Ridenour, PA's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Jonathan Ridenour, PA enrolled in Medicare?
Yes. Jonathan Ridenour, PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jonathan Ridenour, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Jonathan Ridenour, PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Jonathan Ridenour, PA accept?
Health plans from Blue Cross and Blue Shield of Texas list Jonathan Ridenour, PA 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.
When was this NPI record last updated?
The NPPES record for Jonathan Ridenour, PA was last updated on September 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.