NPIMap

Individual provider Active NPI

Gregory Vidovic, DPM, D.ABFAS

  • Foot & Ankle Surgery Podiatrist
  • Shenandoah, TX
National Provider Identifier
1548602212
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2223 Issued in TX
Practice address
101 Vision Park Blvd
Shenandoah, TX 77384-3012
Phone
(281) 363-2829
Fax
(281) 292-1201
NPI assigned
Jul 23, 2013
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2223 TX Primary

Addresses

Primary practice location

101 Vision Park Blvd
Shenandoah, TX 77384-3012

Mailing address

101 Vision Park Blvd
Shenandoah, TX 77384-3012
Phone (281) 363-2829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160708000760 TX Practitioner - Podiatry 1557653755 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buczek and Kobza, PLLCGroup PAC ID 0648168245, 3 clinicians

Practice addresses (Care Compare)

101 Vision Park Blvd
Shenandoah, TX 77384-3011
Phone (281) 363-2829

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pulse Physician Organization PLLC CurrentSince Jan 4, 2023 Accepting new patients
Buczek Kobza LLC CurrentSince Jul 1, 2016 Accepting new patients
Pulse Healthcare System LLC CurrentSince Dec 1, 2025 Accepting new patients
CLS Health PLLC PastSince Sep 24, 2023 Accepting new patients

Locations

21212 Northwest Fwy
Ste 405
Cypress, TX 77429
Phone (281) 890-8586

116 Medical Park Ln
Huntsville, TX 77340
Phone (936) 277-1000

119 Medical Park Ln
Ste D
Huntsville, TX 77340
Phone (936) 277-1000

101 Vision Park Blvd
Shenandoah, TX 77384
Phone (281) 363-2829

25420 Kuykendahl Rd
Ste 700
Tomball, TX 77375
Phone (346) 794-0001

25420 Kuykendahl Rd
Ste 800
Tomball, TX 77375
Phone (346) 794-0001

25450 Kuykendahl Rd
Ste 110
Tomball, TX 77375
Phone (713) 804-1959

Interoperability endpoints

  • Direct secure messaging: gregory.vidovic.1@13131.direct.athenahealth.com
  • Direct secure messaging: gregory.vidovic.1@16739.direct.athenahealth.com
  • Direct secure messaging: gregory.vidovic.1@810.direct.athenahealth.com
  • Direct secure messaging: gregory.vidovic.2@11939.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EIBDCA

Organizations & group practices 4

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.

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1548602212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 VISION PARK BLVD",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843012",
            "telephone_number": "281-363-2829",
            "fax_number": "281-292-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 VISION PARK BLVD",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843012",
            "telephone_number": "281-363-2829",
            "fax_number": "281-292-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDOVIC",
        "first_name": "GREGORY",
        "credential": "DPM, D.ABFAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.