John Paul Vidolin, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

ME0068375 Issued in FL

Practice address

836 Sunset Lake Blvd
Suite 102
Venice, FL 34292-7554

Phone

(941) 497-1771

Fax

(941) 497-1860

NPI assigned

Nov 7, 2005

Last updated

Nov 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• John Paul Vidolin Other name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: john.vidolin@1361.chartlogic.direct-ci.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.

• John Paul Vidolin M D P a

  • Orthopaedic Surgery Physician
  • Venice, FL
  • NPI 1336120484
  Authorized official Same address or phone
• Venice Orthopaedics, P.a.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Venice, FL
  • NPI 1992971717
  Authorized official Same address or phone

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1427039569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 SUNSET LAKE BLVD",
            "address_2": "SUITE 102",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342927554",
            "telephone_number": "941-497-1771",
            "fax_number": "941-497-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 SUNSET LAKE BLVD",
            "address_2": "SUITE 102",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342927554",
            "telephone_number": "941-497-1771",
            "fax_number": "941-497-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDOLIN",
        "first_name": "JOHN PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0068375",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME0068375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "27192Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27192",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "3925180001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN PAUL",
            "last_name": "VIDOLIN",
            "credential": "MD PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Venice Vision LLC
• Angelica Ventresca, LCSW
• Jenny Vest, APRN
• Michael Vicente
• Victor Baga, M.D., P.a.
• Stacy Vigue-Adair, PA
• Eric M Vihlen, M.D.
• Farida Vildanova, APRN
• Francheska Paola Villanueva
• Jimmy Ryan Villarreal, PHARM. D.

• Sports Medicine (Orthopaedic Surgery) Physician in Venice, FL
• Providers in Venice, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.