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MONICA V RILEY CNP
NPI 1770864829
Nurse Practitioner in Hilton Head Island, SC

Active since September 02, 2011PECOS Enrolled
20.64/100
CMS Quality Rating
25 HOSPITAL CENTER BLVD STE 300, HILTON HEAD ISLAND, SC 29926(843) 682-2800(843) 682-2828 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Monica V Riley Cnp NPPES

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

MONICA V RILEY CNP (NPI 1770864829) is an individual nurse practitioner in Hilton Head Island, South Carolina, licensed in South Carolina (17990) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770864829
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMONICA V RILEYCredential: CNP
Location Address25 HOSPITAL CENTER BLVD STE 300Hilton Head Island, SC 29926-2739
Mailing Address1859 N Paris Ave Ste 212Port Royal, SC 29935-2029 · (912) 354-4813 · Fax (912) 354-4813
Phone(843) 682-2800
Fax(843) 682-2828
Sole ProprietorNo
Enumeration DateSeptember 2, 2011
Last NPPES UpdateAugust 31, 2021
NPPES CertifiedAugust 31, 2021
✔ NPI 1770864829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in SC · 17990✔ Licensed in OH · 263283
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
25 HOSPITAL CENTER BLVD STE 300, Hilton Head Island, SC 29926
Open in Google Maps ↗

Other Identifiers 1

Other17990SC · License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Monica V Riley Cnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 3

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
1,274 services857 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.
1,116 services812 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.
194 services181 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29926 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
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.

20.64/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Promoting Interoperability0
Improvement Activities0
Cost68.83

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,731 patients5/55-star benchmark: 100%
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.
92%1,312 patients3/55-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…
48%127 patients3/55-star benchmark: 88%
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.
84%1,113 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
78%1,125 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 431 patients
97%431 patients4/55-star benchmark: 98%
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…
91%1,113 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…
31%1,113 patients2/55-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.
46%1,113 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.

Other Providers at the Same Location NPPES 2

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

DR. AARON JAMES FORD M.D.
Internal Medicine (Cardiovascular Disease)
25 HOSPITAL CENTER BLVD STE 300
HILTON HEAD ISLAND, SC 29926
Beaufort County (843) 682-2800
JONATHAN E MACCABE MD
Internal Medicine (Cardiovascular Disease)
25 HOSPITAL CENTER BLVD STE 300
HILTON HEAD ISLAND, SC 29926
Beaufort County (843) 682-2800

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 Monica Riley's NPI number?

The NPI number for Monica Riley is 1770864829. It was assigned to this individual provider in the NPPES registry on September 2, 2011.

Where is Monica Riley located?

Monica Riley practices at 25 Hospital Center Blvd Ste 300, Hilton Head Island, SC 29926. The listed phone number is (843) 682-2800.

What is Monica Riley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Monica Riley enrolled in Medicare?

Yes. Monica Riley is registered in the Medicare PECOS enrollment system.

What insurance does Monica Riley accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and First Choice Next list Monica Riley 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 Monica Riley was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.