Individual provider Active NPI

Sarkis Gibran Morales Vidal, MD

  • Neurology Physician
  • Maywood, IL
National Provider Identifier
1811211899
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036123939 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Mar 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME125857 FL
Vascular Neurology Physician 2084V0102X 036.123939 IL
Vascular Neurology Physician 2084V0102X ME125857 FL
Neurology Physician 2084N0400X 036123939 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Other practice location 1

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

Other names 1

  • Sarkis G Morales Vidal Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smoralesvidal32051@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20101103001363 IL Practitioner - Neurology 4587858592 Reassigns benefits to 2 organizations
I20151116001594 FL Practitioner - PsychiatryPractitioner - Neurology 4587858592 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.123939ILMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Sep 4, 2010 Accepting new patients
Loyola University Medical Center CurrentSince Sep 4, 2010 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Feb 23, 2021 Accepting new patients
Loyola Medical Group LLC CurrentSince Jul 20, 2019 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Adventist Health System-Sunbelt Inc Current Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Feb 23, 2021 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Feb 23, 2021 Accepting new patients
Pioneer Medical Group, PL Neurology CurrentSince Jul 20, 2019 Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

38250 A Ave
Zephyrhills, FL 33542
Phone (813) 732-5608

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
#150
Maywood, IL 60153

2160 S 1st Ave
#101
Maywood, IL 60153
Phone (708) 216-8785

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

3722 Harlem Ave
Ste 200
Riverside, IL 60546
Phone (708) 447-4999

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1269043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1811211899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13067 N Telecom Pkwy",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336370926",
            "country_code": "US",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORALES VIDAL",
        "first_name": "SARKIS",
        "middle_name": "GIBRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-20",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME125857",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036.123939",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "FL",
            "license": "ME125857",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036123939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoralesvidal32051@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SARKIS",
            "last_name": "MORALES VIDAL",
            "middle_name": "G",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.