Active NPI
Nicholas Anthony Videtti, MD
- Psychiatry Physician
- Ridgewood, NJ
National Provider Identifier
1699861658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MA048736
- Practice address
- 127 Union Street
Suite 109
Ridgewood, NJ 07450 - Phone
- (201) 444-1255
- Fax
- (201) 251-9551
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MA048736 | NJ | Primary |
Addresses
Primary practice location
127 Union Street
Suite 109
Ridgewood, NJ 07450
Mailing address
127 Union Street
Suite 109
Ridgewood, NJ 07450
Phone (201) 444-1255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050225000201 | NJ | Practitioner - Psychiatry | 6204889603 | Practice locations: Ridgewood, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1985
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
127 Union St
Suite 109
Ridgewood, NJ 07450-4436
Phone (201) 444-1255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA048736 | NJ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699861658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 UNION STREET",
"address_2": "SUITE 109",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "07450",
"telephone_number": "201-444-1255",
"fax_number": "201-251-9551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 UNION STREET",
"address_2": "SUITE 109",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "07450",
"telephone_number": "201-444-1255",
"fax_number": "201-251-9551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDETTI",
"first_name": "NICHOLAS",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "MA048736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
- 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.