Ted R Vidal II, PTA, LMT

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A-1516 Issued in NV

Practice address

2350 Ione Rd
Las Vegas, NV 89183-7943

Phone

(702) 790-3000

NPI assigned

Nov 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Prism PT LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1992339824
  NPD

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1740998434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6823 PONDEROSA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182100",
            "telephone_number": "702-665-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 IONE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837943",
            "telephone_number": "702-790-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6823 Ponderosa Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891182100",
            "country_code": "US",
            "telephone_number": "702-665-4054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "TED",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PTA, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-10",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "53320",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NV",
            "license": "NVMT.5574",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-1516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "WebPT.com",
            "affiliation": "N",
            "endpointDescription": "WebPT",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6823 Ponderosa Way",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891182100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rosa Linda Vidal Sarmiento
• Karla Suscely Vidal-Santisteban
• Ariday Vidal
• Edith Vidal
• Lidia Vidal
• Christa Vidales
• Joel Vidana Jr., DPT, OCS, MTC
• Ana Vidaurre Ravello de Bailetti
• Patrick J Vides, APRN-CNP
• Michael Videtto

• Physical Therapy Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapy Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.