Jared Steven Videll, D.O.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

OS-003830-L Issued in PA

Practice address

115 S. Austin Avenue
Ventnor City, NJ 08406-3012

Phone

(609) 823-1989

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Emergency MedicineAlso: Cardiovascular Disease (Cardiology), Internal Medicine

Education

Philadelphia College of Osteopathic Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KND Development 59 LLCGroup PAC ID 3678602802, 176 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• KND Development 59 LLC

  • Hospitalist Physician
  • Philadelphia, PA
  • NPI 1851620496
  Medicare reassignment Care Compare group NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Havertown, PA
  • NPI 1952630626
  NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • Broken Arrow, OK
  • NPI 1922950823
  NPD

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1154397263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S. AUSTIN AVENUE",
            "city": "VENTNOR CITY",
            "state": "NJ",
            "postal_code": "084063012",
            "telephone_number": "609-823-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S. AUSTIN AVENUE",
            "city": "VENTNOR CITY",
            "state": "NJ",
            "postal_code": "084063012",
            "telephone_number": "609-823-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDELL",
        "first_name": "JARED",
        "middle_name": "STEVEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS-003830-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therapy and Living Consultants, PC
• Peace Toleito
• Ventnor Board of Education
• Ventnor Educational Community Complex
• Ventnor Pediatrics Inc
• Eric W. Wade, RPH
• Walgreen Co
• Walgreen Co
• Debra Ann Wilhelm, CRNP
• Joe Dan Williams, D.M.D.

• Cardiovascular Disease Physician in Ventnor City, NJ
• Providers in Ventnor City, NJ by specialty
• Cardiovascular Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.