LIDIA L VIDAL (FNP) – Family Nurse Practitioner, NPI 1093565764

LIDIA L VIDAL (FNP) is a healthcare provider. based in Paterson, New Jersey. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 26NJ15067900 (NJ). The NPI Number for LIDIA L VIDAL (FNP) is 1093565764

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
LIDIA L VIDAL (FNP)
NPI
1093565764
Phone
(973) 523-1800
Address
606 BROADWAY
Enumeration Date
25 March 2024
Last Update Date
31 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9082408142
Graduation Year
2023 (3 years ago)
PAC ID
2769926708
Group Practice PAC ID
0244404697
Professional Enrollment ID
I20240701002508
Address ID
NJ075141916PA606XXBROA200
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:2State licenses:2Digital endpointsOther names

7,515 NURSE PRACTITIONER in NJ

Provider Addresses for LIDIA L VIDAL (FNP)

  • 606 BROADWAY

    PATERSON, NJ 075141916

    Phone: (973) 523-1800

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Amgen Inc. ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-08

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Amgen Inc.$19
View all Open Payments →|Open Payments Risk Radar →

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: 2024-07-01

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
I20240701002508INurse PractitionerNJTBD

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 07514)

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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: 0244404697View full group profile
NameSpecialtyState
-NJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
-NJ
Nurse PractitionerNJ
Internal MedicineNJ
General PracticeAL
Nurse PractitionerNJ

Reviews

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Frequently asked questions

Can I cross-check LIDIA L VIDAL (FNP) using NPI 1093565764?
NPI 1093565764 belongs to LIDIA L VIDAL (FNP); compare other details if you need extra assurance.
Active or inactive — what applies to LIDIA L VIDAL (FNP)?
You should see LIDIA L VIDAL (FNP) as active in CMS-hosted NPPES data.
What expertise is attributed to LIDIA L VIDAL (FNP)?
LIDIA L VIDAL (FNP)'s specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for LIDIA L VIDAL (FNP)?
Travel planning: use Paterson, New Jersey as the reference point for LIDIA L VIDAL (FNP), then confirm.
When was this NPI issued?
Enumeration for LIDIA L VIDAL (FNP) is noted as March 25, 2024 where the registry provides it.

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