Benjamin Vidalis, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD2021-0303 Issued in NM

Practice address

465 Saint Michaels Dr Ste 107
Santa Fe, NM 87505-7690

Phone

(505) 988-3233

Fax

(505) 988-3562

NPI assigned

Apr 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Benjamin Wilson Former name

Medicare fee-for-service enrollment

Enrolled in NM

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

Neurosurgery

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bvidalis263610@christushealth.direct-ci.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.

• St Vincent Hospital

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment Care Compare group
• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  NPD
• St Vincent Hospital

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1861968521
  NPD
• St. Vincent Hospital

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1245438647
  NPD

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

• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1104245562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC 10 5615",
            "address_2": "UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-3160",
            "fax_number": "505-272-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR STE 107",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057690",
            "telephone_number": "505-988-3233",
            "fax_number": "505-988-3562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Msc 10 5615",
            "address_2": "University of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-3160",
            "fax_number": "505-272-9427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDALIS",
        "first_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NM",
            "license": "MD2021-0303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENJAMIN",
            "last_name": "WILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Joyce Victor, M.S.W.
• Gabrielle M Viethen, LMFT
• Destiny Vigil Chavez
• Gerardine Vigil-Bartels, CNP
• Patricia Vigil-Bartrum
• Cathy M Vigil-Martinez, M.S., CCC-SLP

• Neurological Surgery Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Neurological Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.