Jeffrey Joseph Videtto, PT
Individual provider Active NPI Physical Therapist · Bennington, VT
NPI 1720060254 · NPPES record last updated Oct 24, 2011
Key facts
- NPI
- 1720060254
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 0000818 (VT)
- Practice address
- 328 Dewey St
Bennington, VT 05201-2225 - Phone
- (802) 447-2101
- Fax
- (802) 447-1902
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Columbia University College of Physicians and Surgeons, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bennington Physical Therapy PC
Practice addresses (Care Compare)
328 Dewey St
Bennington, VT 05201-2225
Phone (802) 447-2101
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120302000424 | VT | Practitioner - Physical Therapist in Private Practice | 3678555273 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000818 | VT | MD | Physical Therapist |
| 003407 | NY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0000818 | VT | Yes |
Addresses
Primary practice location
328 Dewey St
Bennington, VT 05201-2225
Mailing address
328 Dewey St
Bennington, VT 05201-2225
Phone (802) 447-2101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43169 | Other | VT | MOHAWK VALLEY PLAN |
| 2775 | Other | VT | BCBS OF VT |
Other providers in Bennington, VT
- Vermont Permanency Initiative, Inc.
- Vermont Valley Physical Therapy
- Vermont Veterans Home
- Vermont Veterans' Home
- Matthew R Vernon
- Chito Villarin
- Paul L Vinsel
- Wal-Mart Stores East LP
- Wal-Mart Stores East, LP
- Walgreen Co
All providers in Bennington, VT · Physical Therapist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.