Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Thaddeus Beam Riley, PA

Individual provider Medical Physician Assistant · NPI 1144417999

Mr. Thaddeus Beam Riley, PA is a Physician Assistant in Louisville, Kentucky. Qualified in 2007, 19 years ago. Practices with Dmmd Concierge LLC, a 2-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Kentucky.

Years since qualifying
19
Licensed in
KY
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

947 Eastern Pkwy
Louisville, KY 40217-1573
Phone: (502) 361-8801
Fax: (502) 361-8821
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5601 S 3rd St, Louisville, KY 40214-2615 — (502) 361-8801

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA1070 (KY)

Record details

NPI number1144417999
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 25, 2007
Last updated in NPPESNovember 27, 2023
Certification dateSeptember 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Dmmd Concierge Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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