NPIMap

Individual provider Active NPI

Danko Victor Vidovich, M.D.

  • Neuroradiology Physician
  • Minot, ND
National Provider Identifier
1255420030
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
13101 Issued in ND
Practice address
1 Burdick Expy W
Minot, ND 58701-4406
Phone
(701) 857-5220
Fax
(701) 857-5245
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 210975-1 NY
Neuroradiology Physician 2085N0700X 13101 ND Primary

Addresses

Primary practice location

1 Burdick Expy W
Minot, ND 58701-4406

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5650

Other identifiers 1

IdentifierTypeStateIssuer
01909622MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060315000172 NY Practitioner - Diagnostic Radiology 7416944301 Reassigns benefits to 1 organization
I20230522000065 IL Practitioner - Diagnostic Radiology 7416944301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upmc Chautauqua at WcaGroup PAC ID 4385630342, 26 clinicians

Practice addresses (Care Compare)

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 487-0141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.95 of 100Reported as group
Quality
90.59
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
210975-1NYMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Chautauqua at Wca CurrentSince Oct 20, 2024 Accepting new patients
Upmc Chautauqua at Wca Current Accepting new patients
Upmc Chautauqua at Wca CurrentSince Oct 20, 2024 Accepting new patients
Radiology Consultants of Rockford LTD CurrentSince Oct 1, 2022 Accepting new patients
Doshi Diagnostic Imaging Services PC Past Accepting new patients
Nyumc Radiology Associates Past Accepting new patients
New York University Medical Center Faculty Practice Radiology Past Accepting new patients
Millennium Medical Imaging PC Past Accepting new patients
On-Line Radiology Medical Group Inc Past Accepting new patients
Brooklyn Radiology Services PC Past Accepting new patients
Doshi Diagnostic Imaging Services of New Jersey, LLC Past Accepting new patients

Locations

39020 Eagle Way
Chicago, IL 60678

1215 N Alpine Rd
Rockford, IL 61107
Phone (815) 391-7700

1340 Charles St
Ste 404
Rockford, IL 61104
Phone (815) 316-8346

1340 Charles St
Rockford, IL 61104
Phone (779) 696-5888

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

Interoperability endpoints

  • Direct secure messaging: dvidovich516044@upmc.direct-ci.com

Organizations & group practices 11

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1255420030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BURDICK EXPY W",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014406",
            "telephone_number": "701-857-5220",
            "fax_number": "701-857-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDOVICH",
        "first_name": "DANKO",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "210975-1",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "ND",
            "license": "13101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01909622",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.