MICHELLE VIDAL (NP) – Family Nurse Practitioner, NPI 1164576229
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,971 NURSE PRACTITIONER in MA
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Provider Addresses for MICHELLE VIDAL (NP)
2, Eastland Road, Forest Hills, Jamaica Plain, Boston, Suffolk County, Massachusetts, 02131, United States
JAMAICA PLAIN, MA 021304617
Phone: (617) 699-1738
Type: Mailing
15, Parkman Street, Fields Corner, Dorchester, Boston, Suffolk County, Massachusetts, 02122, United States
WANG BUILDING ROOM 745
BOSTON, MA 021143117
Phone: (617) 726-3303
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-10-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041027000263 | I | Nurse Practitioner | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02130)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | MA | |
| Diagnostic Radiology | MA | |
| Nephrology, Internal Medicine | MA | |
| Nurse Practitioner | MA | |
| P A T H O L O G Y | NY | |
| P A T H O L O G Y | MA | |
| P S Y C H I A T R Y | MA | |
| Cardiac Electrophysiology, Internal Medicine, Cardiovascular Disease (Cardiology) | MA | |
| H E M A T O L O G Y/ O N C O L O G Y | MA | |
| N E U R O L O G Y | MA |
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