NPIMap

Individual provider Active NPI

Lars Widdel, MD

  • Neurological Surgery Physician
  • Redding, CA
National Provider Identifier
1447397708
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
C171096 Issued in CA
Practice address
2624 Edith Ave
Redding, CA 96001-3043
Phone
(530) 806-1190
Fax
(530) 229-7946
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X C171096 CA Primary

Addresses

Primary practice location

2624 Edith Ave
Redding, CA 96001-3043

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521000583 CA Practitioner - Neurosurgery 9032380449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

2624 Edith Ave
Redding, CA 96001-3043
Phone (530) 806-1190

Hospital & facility affiliations

  • Interim Healthcare Home health agency, Redding, CA, CCN 557630
  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
  • St Elizabeth Community Hospital Hospital, Red Bluff, CA, CCN 050042
  • Mercy Medical Center of Mt Shasta Hospital, Mount Shasta, CA, CCN 051319
  • Fairchild Medical Center Hospital, Yreka, CA, CCN 051316
  • Trinity Hospital Hospital, Weaverville, CA, CCN 051315

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion206
Laminectomy or laminotomy (partial removal of spine bones)97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C171096CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Jun 7, 2021 Accepting new patients
Dignity Health Past Accepting new patients
Parkview Medical Center, Inc. Past Accepting new patients
Medical Center of the Rockies Past Accepting new patients
Poudre Valley Health Care Inc. Past Accepting new patients

Locations

2624 Edith Ave
Redding, CA 96001
Phone (530) 241-3316

2510 Airpark Dr
Ste 301
Redding, CA 96001
Phone (530) 242-3500

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

Interoperability endpoints

  • Direct secure messaging: lwiddel90167@directinfirmaryhealth.org

Organizations & group practices 6

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 8

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1447397708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 EDITH AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013043",
            "telephone_number": "530-806-1190",
            "fax_number": "530-229-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDEL",
        "first_name": "LARS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "C171096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.