JOSEPH VIDMAR (CRNA) – Certified Registered Nurse Anesthetist, NPI 1730694548

JOSEPH VIDMAR (CRNA) is a healthcare provider. based in Cloquet, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 2037767 (MN). The NPI Number for JOSEPH VIDMAR (CRNA) is 1730694548

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
JOSEPH VIDMAR (CRNA)
NPI
1730694548
Phone
(218) 879-4641
Address
512 SKYLINE BLVD STE 1
Enumeration Date
4 December 2017
Last Update Date
25 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2188794641
Graduation Year
2017 (9 years ago)
PAC ID
1153681903
Group Practice PAC ID
0042129991
Professional Enrollment ID
I20180216000324
Address ID
MN557203787CL512XXBLVD300

Contacts

Secure Messaging
hisdept@direct.cloquethospital.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:8State licenses:2Other namesUpdated within 12 months

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

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Provider Addresses for JOSEPH VIDMAR (CRNA)

  • 512 SKYLINE BLVD STE 1

    CLOQUET, MN 557201199

    Phone: (218) 879-4641

    Type: Mailing

  • North Memorial Medical Center, 3300, Oakdale Avenue North, Robbinsdale, Hennepin County, Minnesota, 55422, United States

    ROBBINSDALE, MN 554222926

    Phone: (763) 520-5200

    Fax: (763) 257-8356

    Type: Mailing

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: 2018-02-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180216000324ICertified Registered Nurse Anesthetist (Crna)MNTBD

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.

Verify on CMS Revalidation Lookup Tool

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 55720)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042129991View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMN
Nurse PractitionerMN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
N E U R O S U R G E R YMN
-MN
Family PracticeMN
General SurgeryMN

Reviews

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Frequently asked questions

What is the registry number for JOSEPH VIDMAR (CRNA)?
The registry entry for JOSEPH VIDMAR (CRNA) shows NPI 1730694548.
Is JOSEPH VIDMAR (CRNA) currently accepting referrals based on NPI status?
Registry metadata lists JOSEPH VIDMAR (CRNA) as active.
Which specialty label fits JOSEPH VIDMAR (CRNA)?
NPPES ties JOSEPH VIDMAR (CRNA) to Certified Registered Nurse Anesthetist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JOSEPH VIDMAR (CRNA)?
JOSEPH VIDMAR (CRNA) is associated with Cloquet, Minnesota in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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