Daniel Evan Viders, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

75666 Issued in MA

Practice address

207 Southbridge St
Auburn, MA 01501-2548

Phone

(508) 832-7118

Fax

(508) 832-4758

NPI assigned

Aug 25, 2005

Last updated

Nov 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 17

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Dermatology

Education

University of Colorado School of Medicine, Denver, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Daniel E Viders MD PCGroup PAC ID 9931154283, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019
• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Daniel E Viders MD PC

  • Dermatology Physician
  • Auburn, MA
  • NPI 1033163126
  Medicare reassignment Care Compare group Authorized official
• Fall River Dermatology PC

  • Dermatology Physician
  • Fall River, MA
  • NPI 1811232820
  Authorized official Same address or phone
• Central Mass Dermatology PC

  • Procedural Dermatology Physician
  • Southbridge, MA
  • NPI 1730339284
  NPD (past)
• CRV Dermatology LLC

  • Physician Assistant
  • Enfield, CT
  • NPI 1790800480
  NPD (past)
• Rhode Island Dermatology Obs

  • Ambulatory Surgical Clinic/Center
  • Lincoln, RI
  • NPI 1235202201
  NPD (past)
• United Specialists Pathology Laboratory Inc

  • Clinical Medical Laboratory
  • Lincoln, RI
  • NPI 1417241555
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Umass Memorial Health-Harrington Hospital Inc

  • General Acute Care Hospital
  • Southbridge, MA
  • NPI 1790780047
  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1558354407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SOUTHBRIDGE ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012548",
            "telephone_number": "508-832-7118",
            "fax_number": "508-832-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 SOUTHBRIDGE ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012548",
            "telephone_number": "508-832-7118",
            "fax_number": "508-832-4758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Southbridge St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "MA",
            "postal_code": "015012548",
            "country_code": "US",
            "telephone_number": "508-832-7118",
            "fax_number": "508-832-4758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDERS",
        "first_name": "DANIEL",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "042219",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "11477",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "75666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "043158835",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MASS",
            "identifier": "J12248",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TITLE 19 INS",
            "identifier": "001422196",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "997001",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P1705911",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY",
            "identifier": "00142219600",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "010075666M02",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTH NET",
            "identifier": "000000028685",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PLANS",
            "identifier": "0303009",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS MASS",
            "identifier": "075666",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "010042219CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH OF NEW ENGLAND",
            "identifier": "17462",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3092917",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V2311",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "4294",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTH CARE",
            "identifier": "620067",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "758835",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• USA Extended Care, Inc.
• Bryanna Vail, LMHC
• Matthew Valcourt, DMD
• Tammy E Vargas, M.D.
• Jeannece Vega Zayas
• Visiting Nurse Association of Southern Worcester County Inc. (Central MA Hospice)
• Vistacare of Boston, LLC (Gentiva)
• Vivek Mehta DMD PC (Welcome Smiles)
• Deborah Ann Vuillemot, ARNP, CNM
• Carol J Walsh

• Dermatology Physician in Auburn, MA
• Providers in Auburn, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.