Individual provider Active NPI

Erez Vidan, M.D.

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1982818373
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1015001 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3850
NPI assigned
May 9, 2007
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 238696 NY
Nuclear Radiology Physician 2085N0904X 1015001 MA
Diagnostic Radiology Physician 2085R0202X 0101259946 VA
Diagnostic Radiology Physician 2085R0202X 1015001 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-5610

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address evidan107779@direct.urmc.rochester.edu Direct
Direct Messaging Address evidan107779@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NV, VA, CT4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20230601003072 MA Practitioner - Diagnostic Radiology 8022206572 Reassigns benefits to 3 organizations
I20240813004115 NV Practitioner - Diagnostic Radiology 8022206572 Reassigns benefits to 2 organizations
I20250729002947 VA Practitioner - Diagnostic Radiology 8022206572 Reassigns benefits to 1 organization
I20260618003554 CT Practitioner - Diagnostic Radiology 8022206572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Providers LLCGroup PAC ID 1456629369, 264 clinicians
Universal Radiology Partners of NevadaGroup PAC ID 5799295259, 71 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-5610

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

148 Chestnut St
Needham, MA 02492-2505
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (702) 388-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101259946VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St James Hospital CurrentSince Jan 6, 2018 Accepting new patients
Physicians of University Hospital, PC CurrentSince May 2, 2016 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jun 24, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 5, 2025 Accepting new patients
Empire State Radiology P C Diagnostic Radiology CurrentSince Apr 5, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 5, 2025 Accepting new patients
Physicians of University Hospital, PC CurrentSince May 2, 2016 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jun 24, 2024 Accepting new patients
Universal Radiology Partners of Nevada LLC Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
Mary Washington Healthcare Providers LLC Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jun 30, 2023 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Oct 5, 2025 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jun 30, 2023 Accepting new patients
Virtual Radiologic Professionals of New York, P.a. Diagnostic Radiology Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

60 Hospital Rd
#3
Leominster, MA 01453

157 Union St
Marlborough, MA 01752
Phone (508) 481-5000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

10 Little Brook Rd
West Wareham, MA 02576

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

360 S Lola Ln
Pahrump, NV 89048
Phone (775) 751-7500

6500 Longley Ln
Reno, NV 89511
Phone (775) 331-7000

411 Canisteo St
Hornell, NY 14843
Phone (607) 324-8000

7309 Seneca Rd N
Ste 108
Hornell, NY 14843
Phone (607) 385-3790

7329 Seneca Rd N
North Hornell, NY 14843
Phone (607) 247-2200

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

Interoperability endpoints

  • Direct secure messaging: evidan136069@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 10

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1982818373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Sam Perry Blvd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014453",
            "country_code": "US",
            "telephone_number": "540-741-5610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAN",
        "first_name": "EREZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "238696",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MA",
            "license": "1015001",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101259946",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1015001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evidan107779@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evidan107779@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.