Individual provider Active NPI

Victoria Ann Rabidue, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1346908415
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027963 Issued in NY
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 859-2342
NPI assigned
Dec 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027963 NY Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

763 Columbus Pkwy
Buffalo, NY 14213-2413

Other practice location 1

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 826-7000

Other practice location 2

763 Columbus Pkwy
Buffalo, NY 14213-2413
Phone (989) 701-0186

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220216000353 NY Practitioner - Physician Assistant 2365835345 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

875 Ellicott St
Buffalo, NY 14203-1070
Phone (716) 710-8266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027963NYMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: vrabidue@gppc.medentdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1346908415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 COLUMBUS PKWY",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-2342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Abbott Rd",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142202039",
            "country_code": "US",
            "telephone_number": "716-826-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "763 Columbus Pkwy",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142132413",
            "country_code": "US",
            "telephone_number": "989-701-0186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RABIDUE",
        "first_name": "VICTORIA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-06",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.