Thomas R. Vidic, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

01033614A Issued in IN

Practice address

303 S Nappanee St
Elkhart, IN 46514-2066

Phone

(574) 296-3282

Fax

(574) 296-3324

NPI assigned

Jun 15, 2005

Last updated

Dec 19, 2012By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Neurology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Indiana LLCGroup PAC ID 2365341674, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Valparaiso, IN, CCN 157095
• Aunova Home Care LLC Home health agency, Granger, IN, CCN 157683
• Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
• Goshen Hospital Hospital, Goshen, IN, CCN 150026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomas.vidic.1@31626.direct.athenahealth.com
• Direct secure messaging: thomas.vidic@elkhartc.eclinicaldirectplus.com

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

• Privia Medical Group Indiana, LLC

  • Multi-Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1013912286
  Medicare reassignment Care Compare group NPD
• Privia Medical Group Indiana, LLC

  • Multi-Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1083165708

  Neurology

  NPD
• Privia Medical Group Indiana, LLC

  • Family Nurse Practitioner
  • Wakarusa, IN
  • NPI 1568147809
  NPD

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

• Aunova Home Care, LLC

  • Home Health Agency
  • Granger, IN
  • NPI 1679969489
  Care Compare affiliation
• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  Care Compare affiliation
• GLC Home Health Nin LLC

  dba Elara Caring

  • Home Health Agency
  • Valparaiso, IN
  • NPI 1013493493
  Care Compare affiliation
• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1265437404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2968",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465152968",
            "telephone_number": "574-296-3282",
            "fax_number": "574-296-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142066",
            "telephone_number": "574-296-3282",
            "fax_number": "574-296-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDIC",
        "first_name": "THOMAS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01033614A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112810A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sanjay Vasudeva, MD
• Karla Vela
• Elvis Velez
• Barbara A Vernon, MA, LMHC
• Mary J Verstraete, CRNA
• Lauren Luisa Vincent
• Vitela Therapy and Healing LLC
• Jona Vitela, MSW, LCSW, LCAC
• Rachel J Voth Schrag
• Jennifer Suzanne Wade, O.D.

• Neurology Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.