Individual provider Active NPI

Nahid Y Vidal, M.D.

  • MOHS-Micrographic Surgery Physician
  • Rochester, MN
National Provider Identifier
1316269103
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
60361 Issued in MN
Practice address
200 1St Street SW
Rochester, MN 55905
Phone
(507) 284-2511
NPI assigned
Feb 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 60361 MN Primary
Dermatology Physician 207N00000X 60361 MN
Dermatology Physician 207N00000X 18150 NH
MOHS-Micrographic Surgery Physician 207ND0101X 18150 NH

Addresses

Primary practice location

200 1St Street SW
Rochester, MN 55905

Mailing address

200 1St Street SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

200 1st Street SW Dermatology
Rochester, MN 55905
Phone (507) 284-2511

Other names 1

  • Nahid Yakuby Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nvidal625448@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20160616000232 MN Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 7416191762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)Also: Dermatology
Education
University of California, Davis School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision91
Removal of skin lesions119
Removal of skin cancer312
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18150NHMDDermatology Physician

Interoperability endpoints

  • Direct secure messaging: nvidal625448@ehrdirect.mayoclinicmsg.org

Organizations & group practices 1

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 1

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": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1316269103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST STREET SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST STREET SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st Street SW Dermatology",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "55905",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "NAHID",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MN",
            "license": "60361",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "60361",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NH",
            "license": "18150",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NH",
            "license": "18150",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvidal625448@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st Street SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NAHID",
            "last_name": "YAKUBY",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.