| Dr Thomas R Vidic, MD | |
|
303 S Nappanee St, Elkhart, IN 46514-2066 | |
| (574) 296-3282 | |
| (574) 296-3324 |
| Full Name | Dr Thomas R Vidic |
|---|---|
| Gender | Male |
| Speciality | Neurology |
| Experience | 46 Years |
| Location | 303 S Nappanee St, Elkhart, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265437404 | NPI | - | NPPES |
| 100112810A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 01033614A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Elkhart General Hospital | Elkhart, IN | Hospital |
| Goshen Hospital | Goshen, IN | Hospital |
| Memorial Hospital Of South Bend | South bend, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Privia Medical Group Indiana, Llc | 2365341674 | 39 |
| Entity Name | Privia Medical Group Indiana, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568147809 PECOS PAC ID: 2365341674 Enrollment ID: O20040110000052 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thomas R Vidic, MD Po Box 2968, Elkhart, IN 46515-2968 Ph: (574) 296-3282 | Dr Thomas R Vidic, MD 303 S Nappanee St, Elkhart, IN 46514-2066 Ph: (574) 296-3282 |
Susan Taccheri, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2600 Oakland Ave, Elkhart, IN 46517 Phone: 574-533-1234 Fax: 574-537-2652 | |
Dr. Preeya Patel Grewal, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 145 S Nappanee St, Elkhart, IN 46514 Phone: 574-304-1519 Fax: 574-333-2979 | |
Dr. Douglas L. Jarvis, D.O. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 56218 Parkway Ave, Suite B, Elkhart, IN 46516 Phone: 574-293-0005 Fax: 574-293-0019 | |
Dr. Sadeq Al-sarraf, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2600 Oakland Ave, Elkhart, IN 46517 Phone: 574-533-1234 Fax: 574-537-2652 | |
Dr. Suying Wu, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 303 S Nappanee St, Elkhart, IN 46514 Phone: 574-296-3282 Fax: 574-296-3324 | |
Timothy C Mcfadden, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2600 Oakland Ave, Elkhart, IN 46517 Phone: 574-533-1234 Fax: 574-537-2652 |