Elizabeth Jane Videlock, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

250421 Issued in MA

Practice address

10 Wayman LN
Mdi Hospital
Bar Harbor, ME 04609-1625

Phone

(207) 288-5082

Fax

(207) 288-8600

NPI assigned

Jun 18, 2009

Last updated

Mar 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Merit-based Incentive Payment System (MIPS)

Final score

87.51 of 100Reported as group

Quality

79.37

Promoting interoperability

100

Improvement activities

40

Cost

73.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evidelock151056@direct.uclahealth.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/b5eba017-85d4-4b6c-a2f0-9b2c7b0c38dd/

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.

• The Regents of the University of California

  dba UCLA Dept of Medicine

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566
  Medicare reassignment NPD
• The Regents of the University of California

  dba UCLA Dept of Medicine

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• Mount Desert Island Hospital

  dba Community Dental Center

  • Dental Clinic/Center
  • Southwest Harbor, ME
  • NPI 1235553413
  NPD (past)
• Mount Desert Island Hospital

  • Critical Access Hospital
  • Bar Harbor, ME
  • NPI 1790764512
  NPD (past)
• Mousam Valley Orthopaedics PA

  • Orthopaedic Surgery Physician
  • Sanford, ME
  • NPI 1043374044
  NPD (past)
• The Medical Group Department of Goodall Hospital

  • Family Medicine Physician
  • Kennebunk, ME
  • NPI 1356356869
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1356578272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WAYMAN LN",
            "address_2": "MDI HOSPITAL",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091625",
            "telephone_number": "207-288-5082",
            "fax_number": "207-288-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WAYMAN LN",
            "address_2": "MDI HOSPITAL",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091625",
            "telephone_number": "207-288-5082",
            "fax_number": "207-288-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDELOCK",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "TD 121060",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "250421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon David Tierney, RN
• Jessie K Tilden, CNM
• Lauren Myers Towle, MD
• Town of Bar Harbor
• Mary Grace Trenholm
• Rebekah Joy Villarreal, MD
• Walgreen Eastern Co Inc (Walgreens #19967)
• Lisa Walker, LMHC, LCPC
• Kaity E Walsh
• Katie Elizabeth Walton, LCPC

• Internal Medicine Physician in Bar Harbor, ME
• Providers in Bar Harbor, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.