Individual provider Active NPI

Rebecca Taylor Vidal, PA-C

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1952071870
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0012060 Issued in DE
Practice address
4755 Ogletown Stanton Rd Ste 2670
Newark, DE 19718-4917
Phone
(302) 733-2438
Fax
(302) 733-4832
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0012060 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd Ste 2670
Newark, DE 19718-4917

Mailing address

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (347) 439-2372

Other practice location 1

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (302) 994-2511

Other practice location 2

501 W 14th St
Wilmington, DE 19801-1013
Phone (302) 733-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240722003955 DE Practitioner - Physician Assistant 5991241325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

1401 Foulk Rd
Wilmington, DE 19803-2764

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

501 W 14TH St
Wilmington, DE 19801-1013

501 W 14TH St FL
6 CCHS Infectious Disease
Wilmington, DE 19801-1013
Phone (302) 320-1300

501 W 14TH St Wilmington Hospital
Wilmington, DE 19801-1013

621 Middletown Odessa Rd
Middletown, DE 19709-9602
Phone (302) 203-2260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C5-0012060DEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Jul 10, 2024 Accepting new patients
Christiana Care Health Services, Inc CurrentSince Jul 10, 2024 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Ste 2670
Newark, DE 19718
Phone (302) 584-2601

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

501 W 14th St
#4154
Wilmington, DE 19801
Phone (302) 428-4175

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

Organizations & group practices 3

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 1

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1952071870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "347-439-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 2670",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197184917",
            "telephone_number": "302-733-2438",
            "fax_number": "302-733-4832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Kirkwood Hwy",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198054917",
            "country_code": "US",
            "telephone_number": "302-994-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 W 14th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011013",
            "country_code": "US",
            "telephone_number": "302-733-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "REBECCA",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2024-07-10",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0012060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.