Octavio J. Vidal, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

32673 Issued in AZ

Practice address

3550 S Velero St
Chandler, AZ 85286-2681

Phone

(480) 883-8108

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: gehovidal@yourcarecommunity.org

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• Gilford Sound Emergency Physicians LLC

  • Emergency Medicine Physician
  • Vero Beach, FL
  • NPI 1760996300
  Medicare reassignment NPD
• Houston County Emergency Group, LLC

  • Emergency Medicine Physician
  • Warner Robins, GA
  • NPI 1013338193
  Medicare reassignment NPD
• W4P LLC

  dba Hernando County Emergency Physicians

  • Emergency Medicine Physician
  • Spring Hill, FL
  • NPI 1689116618
  Medicare reassignment NPD
• Houston County Emergency Group, LLC

  • Emergency Medicine Physician
  • Perry, GA
  • NPI 1467873547
  NPD
• Az Corridor Emergency Physicians

  • Emergency Medicine Physician
  • Casa Grande, AZ
  • NPI 1316152333
  NPD (past)
• Casa Grande Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Casa Grande, AZ
  • NPI 1871589051
  NPD (past)
• Mountain Vista Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1164642963
  NPD (past)
• Willard Emergency Physicians

  • Emergency Medicine Physician
  • Cottonwood, AZ
  • NPI 1598714743
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1740253061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847854",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847854",
            "telephone_number": "800-377-8721",
            "fax_number": "304-523-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 S VELERO ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852862681",
            "telephone_number": "480-883-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "OCTAVIO",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "32673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "878225",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "AZ0768990",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Paull Vice, RDH
• Kelly Vickrey
• Nicholas Victor, PT
• Victory Manor LLC.
• Judit Vidacs, PA
• Suzanne Mary Vienuzis, PA-C
• Aitanna Raquel Vigil
• Carrie A Vigue
• Raquel Vigueria, NMD
• Sarita Vijay, NP

• Emergency Medicine Physician in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.