RILEY OSTERTAG PA-C
NPI 1801290614
Physician Assistant - Medical in Prior Lake, MN

Q: What is Riley Ostertag's NPI number?

The NPI number for Riley Ostertag is 1801290614. It was assigned to this individual provider in the NPPES registry on October 22, 2014. The provider is also known as Riley Blythe Pa-C.

Q: What is Riley Ostertag's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Riley Ostertag was last updated on July 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since October 22, 2014PECOS Enrolled

2330 SIOUX TRL NW, PRIOR LAKE, MN 55372(952) 496-6150(952) 233-4224 Get Directions Write a Review

NPPES record last updated: July 22, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Riley Ostertag Pa-c NPPES

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

RILEY OSTERTAG PA-C (NPI 1801290614) is an individual medical provider in Prior Lake, Minnesota, licensed in Minnesota (11694) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1801290614

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameRILEY OSTERTAGCredential: PA-C

Location Address2330 SIOUX TRL NWPrior Lake, MN 55372-9077

Mailing Address2330 Sioux Trl NwPrior Lake, MN 55372-9077 · (952) 496-6150 · Fax (952) 233-4224

Phone(952) 496-6150

Fax(952) 233-4224

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateOctober 22, 2014

Last NPPES UpdateJuly 22, 2015

✔ NPI 1801290614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in MN · 11694

2330 SIOUX TRL NW, Prior Lake, MN 55372

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Other Names 1

Former Name (1)Riley Blythe Pa-c

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Riley Ostertag Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2163749946

PECOS Enrollment IDI20250922001602

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.

Other Providers at the Same Location NPPES 15

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

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