Individual provider Active NPI

Petra Marija Vidmar, APRN

  • Family Nurse Practitioner
  • Danbury, CT
National Provider Identifier
1881544740
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
114266 Issued in CT
Practice address
12 Capitola Rd
Danbury, CT 06811-2911
Phone
(203) 994-1026
NPI assigned
Jan 30, 2026
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 359277 NY
Family Nurse Practitioner 363LF0000X 114266 CT Primary

Addresses

Primary practice location

12 Capitola Rd
Danbury, CT 06811-2911

Mailing address

3 Sugar Hollow Rd
Danbury, CT 06810-7401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260608000801 CT Practitioner - Nurse Practitioner 2062983398 Reassigns benefits to 1 organization
I20260624004438 NY Practitioner - Nurse Practitioner 2062983398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5555 Glenridge Connector
Suite 700
Atlanta, GA 30342-1681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114266CTMDFamily Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1881544740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SUGAR HOLLOW RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CAPITOLA RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068112911",
            "telephone_number": "203-994-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDMAR",
        "first_name": "PETRA",
        "middle_name": "MARIJA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "359277",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "114266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.