Individual provider Active NPI

Jorge Alberto Vidaurre, MD

  • Epilepsy Physician
  • Columbus, OH
National Provider Identifier
1699736165
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
35.087257 Issued in OH
Practice address
555 S 18TH St
Columbus, OH 43205-2696
Phone
(614) 722-6200
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Epilepsy Physician 2084E0001X 35.087257 OH Primary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 35087257 OH
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 35087257 OH
Clinical Neurophysiology Physician 2084N0600X 35087257 OH

Addresses

Primary practice location

555 S 18TH St
Columbus, OH 43205-2696

Mailing address

555 S 18TH St
Columbus, OH 43205-2696
Phone (614) 722-2000

Other practice location 1

1611 27th St
Portsmouth, OH 45662-6931
Phone (614) 722-6200

Other practice location 2

405 Butterfly Gardens Dr
Columbus, OH 43215-4985
Phone (614) 722-6200

Other practice location 3

6435 E Broad St
Columbus, OH 43213-1507
Phone (614) 722-6200

Other practice location 4

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-6200

Other practice location 5

584 County Line Rd W
Westerville, OH 43082-7295
Phone (614) 722-2000

Other practice location 6

433 N Cleveland Ave
Westerville, OH 43082-8095
Phone (614) 722-2000

Other practice location 7

536 S Trimble Rd
Mansfield, OH 44906-3418
Phone (614) 722-6200

Other practice location 8

3949 N Main St
Findlay, OH 45840-4200
Phone (614) 722-6200

Other practice location 9

5675 Venture Dr
Dublin, OH 43017-2159
Phone (614) 722-6200

Other identifiers 2

IdentifierTypeStateIssuer
4177661OtherOHCGS - MEDICARE
0080530MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20060207000997 OH Practitioner - NeurologyPractitioner - Pediatric Medicine 4385659671 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35087257OHMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Children'S Hospital CurrentSince Sep 2, 2024 Accepting new patients
Pediatric Academic Association, Inc. CurrentSince Jan 1, 2006 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 2, 2024 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

Dept 781629
Detroit, MI 48278

Dept L289
Columbus, OH 43260

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

6435 E Broad St
Columbus, OH 43213
Phone (614) 355-8100

405 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 722-4200

555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

5675 Venture Dr
Dublin, OH 43017
Phone (614) 355-9580

3949 N Main St
Findlay, OH 45840
Phone (419) 423-3888

536 S Trimble Rd
Mansfield, OH 44906
Phone (419) 528-3150

433 N Cleveland Ave
Westerville, OH 43082
Phone (614) 355-8300

455 Executive Campus Dr
Westerville, OH 43082
Phone (614) 355-6100

584 County Line Rd W
Westerville, OH 43082
Phone (614) 355-6052

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1699736165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S 18TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052696",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 18TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052696",
            "telephone_number": "614-722-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 27th St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456626931",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154985",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6435 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131507",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "584 County Line Rd W",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430827295",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 N Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828095",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3949 N Main St",
            "address_purpose": "LOCATION",
            "city": "Findlay",
            "state": "OH",
            "postal_code": "458404200",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5675 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAURRE",
        "first_name": "JORGE",
        "middle_name": "ALBERTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "OH",
            "license": "35.087257",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "OH",
            "license": "35087257",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OH",
            "license": "35087257",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OH",
            "license": "35087257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGS - MEDICARE",
            "identifier": "4177661",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080530",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.