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CRAIG MICHAEL RILEY M.D.
NPI 1861734105
Internal Medicine in West Chester, PA

Active since March 25, 2013PECOS EnrolledAccepts Medicare Assignment
86.75/100
CMS Quality Rating
701 E MARSHALL ST, WEST CHESTER, PA 19380(610) 431-5000(610) 431-5025 Get Directions Write a Review

NPPES record last updated: June 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 29, 2020, May 8, 2017 (2 updates tracked since 2017).

About Craig Michael Riley M.d. NPPES

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

CRAIG MICHAEL RILEY M.D. (NPI 1861734105) is an individual internal medicine provider in West Chester, Pennsylvania, licensed in Pennsylvania (MD460581) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of University Of Pittsburgh School Of Medicine (2013).

NPPES Registry Identity

NPI1861734105
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameCRAIG MICHAEL RILEYCredential: M.D.
Location Address701 E MARSHALL STWest Chester, PA 19380-4412
Mailing Address701 E Marshall StWest Chester, PA 19380-4412 · (610) 431-5000 · Fax (610) 431-5025
Phone(610) 431-5000
Fax(610) 431-5025
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 2013
Enumeration DateMarch 25, 2013
Last NPPES UpdateJune 29, 20202 updates tracked since enumeration
NPPES CertifiedJune 29, 2020
✔ NPI 1861734105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD460581
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
701 E MARSHALL ST, West Chester, PA 19380
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Craig Michael Riley M.d. 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 ID4981926128
PECOS Enrollment IDI20190320003382
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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
112 services80 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
63 services41 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
43 services34 patients

Hospital Affiliations CMS Care Compare 2

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

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Chester County Hospital

Acute Care Hospitals · West Chester, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390179
Location701 East Marshall StreetWest Chester, PA 19380 · Chester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19380 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

86.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.91
Promoting Interoperability100
Improvement Activities40

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.

NINA RUTH MAZZARELLI RN, BSN
Registered Nurse
701 E MARSHALL ST
WEST CHESTER, PA 19380
Chester County (610) 431-5000
CHESTER COUNTY HOSPITAL SPU
General Acute Care Hospital
701 E MARSHALL ST
WEST CHESTER, PA 19380
Chester County (610) 431-5000
ELISABETH ANNE CARTER MHS
Physician Assistant
701 E MARSHALL ST
WEST CHESTER, PA 19380
Chester County (610) 431-5150
JENNIFER M. BINGNEAR CRNA
Nurse Anesthetist, Certified Registered
701 E MARSHALL ST, NRW 141
WEST CHESTER, PA 19380
Chester County (610) 431-5472
PROF. AMANDA BRAUNSTEIN PA-C
Physician Assistant (Medical)
701 E MARSHALL ST
WEST CHESTER, PA 19380
Chester County (610) 431-5000
EMERGENCY CARE SPECIALISTS, PC
Emergency Medicine
701 E MARSHALL ST
WEST CHESTER, PA 19380
Chester County (610) 431-5150
MISS SARA ELIZABETH STERLING DO
Hospitalist
701 E MARSHALL ST
WEST CHESTER, PA 19380
Chester County (610) 431-5000
ANNAMARIE KOLLER D.O.
Pediatrics
701 E MARSHALL ST
WEST CHESTER, PA 19380
Chester County (610) 431-5376

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 Craig Riley's NPI number?

The NPI number for Craig Riley is 1861734105. It was assigned to this individual provider in the NPPES registry on March 25, 2013.

Where is Craig Riley located?

Craig Riley practices at 701 E Marshall St, West Chester, PA 19380. The listed phone number is (610) 431-5000.

What is Craig Riley's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Craig Riley enrolled in Medicare?

Yes. Craig Riley 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.

What insurance does Craig Riley accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Craig 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.

Is Craig Riley affiliated with any hospitals?

According to CMS data, Craig Riley is affiliated with Hospital Of Univ Of Pennsylvania and Chester County Hospital.

When was this NPI record last updated?

The NPPES record for Craig Riley was last updated on June 29, 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.