Individual provider Active NPI

Steven B Vidrine, MD

  • Family Medicine Physician
  • Ville Platte, LA
National Provider Identifier
1720125511
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
019490 Issued in LA
Practice address
417 E Lincoln Rd
Ville Platte, LA 70586-3431
Phone
(337) 363-8033
Fax
(337) 363-4571
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 019490 LA Primary

Addresses

Primary practice location

417 E Lincoln Rd
Ville Platte, LA 70586-3431

Mailing address

417 E Lincoln Rd
Ville Platte, LA 70586-3431
Phone (337) 363-8033

Other identifiers 1

IdentifierTypeStateIssuer
1378046MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110217000612 LA Practitioner - Family Practice 1759562143 Practice locations: Ville Platte, LA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

417 E Lincoln Rd
Ville Platte, LA 70586-3431
Phone (337) 363-8033

Hospital & facility affiliations

  • Mercy Regional Medical Center Hospital, Ville Platte, LA, CCN 190167
  • Opelousas General Health System Hospital, Opelousas, LA, CCN 190017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019490LAMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mrmsvidri@yourcarecommunity.org

Hospital & facility affiliations 2

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1720125511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E LINCOLN RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705863431",
            "telephone_number": "337-363-8033",
            "fax_number": "337-363-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 E LINCOLN RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705863431",
            "telephone_number": "337-363-8033",
            "fax_number": "337-363-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "STEVEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "019490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1378046",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ville Platte, LA

Sources for this page

Verify at the official NPI Registry.