Corinne Brooke Vidulich, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

301007-01 Issued in NY

Practice address

271 Route 25a Ste 2
Wading River, NY 11792-2014

Phone

(631) 727-4950

NPI assigned

Apr 1, 2016

Sex

Female

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 NY

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

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: cvidulich299109@northwell.direct-ci.com
• Direct secure messaging: corinnevidulich@nslijmedgr.allscriptsdirect.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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Planned Parenthood Hudson Peconic Inc.

  • Ambulatory Family Planning Facility
  • Smithtown, NY
  • NPI 1285701672
  Medicare reassignment NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• Sun River Health Inc

  • Adult Day Care Clinic/Center
  • Bronx, NY
  • NPI 1740763275
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD
• Planned Parenthood HP

  • Health Maintenance Organization
  • West Islip, NY
  • NPI 1588729560
  NPD (past)

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1225491772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 FRONT ST APT 5",
            "city": "GREENPORT",
            "state": "NY",
            "postal_code": "119441639",
            "telephone_number": "917-655-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 ROUTE 25A STE 2",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922014",
            "telephone_number": "631-727-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDULICH",
        "first_name": "CORINNE",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "301007-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Turner, LCSW CASAC
• Erik Michael Ulrich, LCSW
• Unbridled Aesthetics
• Sarah Verneuille, RN
• Dawn Verni
• Kim Ann Vitacco, NP
• Wading River Complete Dental Care PC
• Wading River Fire District
• Wading River Medical Care PC
• Wading River Pediatric Dentistry, PC

• Family Medicine Physician in Wading River, NY
• Providers in Wading River, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.