John S Videen, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G59271 Issued in CA

Practice address

752 Medical Center CT
Suite 302
Chula Vista, CA 91911-6658

Phone

(619) 421-3361

Fax

(619) 656-8936

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

NephrologyAlso: Internal Medicine

Education

University of Arizona College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Balboa Nephrology Medical Group IncGroup PAC ID 9638164015, 78 clinicians

Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresenius Medical Care East Lakes Dialysis facility, Chula Vista, CA, CCN 552745
• USRC Chula Vista Dialysis Dialysis facility, Chula Vista, CA, CCN 552762
• FMC-Balboa South Bay Home Therapies Dialysis facility, Chula Vista, CA, CCN 552677
• Bridge Home Health Home health agency, San Diego, CA, CCN 059387
• Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222
• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jvideen10478@direct.acumenmd.com
• Direct secure messaging: jvideen81717@scrippshlth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Balboa Nephrology Medical Group, Inc.

  • Nephrology Physician
  • San Diego, CA
  • NPI 1316997505
  Medicare reassignment Care Compare group NPD
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment Care Compare group NPD
• Balboa Nephrology Medical Group,Inc.

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
  • NPI 1598276404
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• John Videen MD,Inc

  • Internal Medicine Physician
  • Chula Vista, CA
  • NPI 1891893848
  NPD (past)
• Sharp Chula Vista Medical Center

  • Skilled Nursing Facility
  • Chula Vista, CA
  • NPI 1538142369
  NPD (past)
• Sharp Coronado Hospital and Healthcare Center

  • General Acute Care Hospital
  • Coronado, CA
  • NPI 1154304475
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresenius Medical Care Balboa, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chula Vista, CA
  • NPI 1588988646

  Dialysis facility

  Care Compare affiliation Name & address match
• Fresenius Medical Care East Lakes, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chula Vista, CA
  • NPI 1679814768

  Dialysis facility

  Care Compare affiliation Name & address match
• Innovative Dialysis Centers of la Jolla LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chula Vista, CA
  • NPI 1992131395

  Dialysis facility

  Care Compare affiliation Name & address match
• Abc Home Health Care LLC

  • Home Health Agency
  • San Diego, CA
  • NPI 1629207287
  Care Compare affiliation
• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Sharp Chula Vista Medical Center

  • General Acute Care Hospital
  • Chula Vista, CA
  • NPI 1396728630
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1043318199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 450",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920378411",
            "telephone_number": "858-810-0000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 MEDICAL CENTER CT",
            "address_2": "SUITE 302",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116658",
            "telephone_number": "619-421-3361",
            "fax_number": "619-656-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDEEN",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G59271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G592710",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SO. CALIFORNIA PTAN",
            "identifier": "BD830S",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO. CALIFORNIA PTAN",
            "identifier": "CA108496",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Victoria
• Maria Victorino
• Melisa Victorino
• Brenda Vidaca
• Luis Vidaurri, DDS
• Paolo Conrado Castillo Viejo, P.T.
• Tiffany Vien-Sanchez
• Michell Sarai Vieyra Siqueiros
• Victoria Vigil
• Jessica Vigo

• Nephrology Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.