Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

VICTOR COLLAZO VIDALES JR.
NPI 1184246704
Physician Assistant in Sacramento, CA

Q: What is Victor Vidales's NPI number?

The NPI number for Victor Vidales is 1184246704. It was assigned to this individual provider in the NPPES registry on May 18, 2020.

Q: What is Victor Vidales's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Victor Vidales was last updated on July 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 18, 2020PECOS EnrolledAccepts Medicare Assignment

3701 J ST STE 201, SACRAMENTO, CA 95816(916) 569-8484 Get Directions Write a Review

NPPES record last updated: July 7, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 7, 2026, May 18, 2020 (2 updates tracked since 2020).

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About Victor Collazo Vidales Jr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICTOR COLLAZO VIDALES JR. (NPI 1184246704) is an individual physician assistant in Sacramento, California, licensed in California (62028) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1184246704

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameVICTOR COLLAZO VIDALES JR.

Location Address3701 J ST STE 201Sacramento, CA 95816-5542

Mailing Address1860 Howe Ave Ste 440Sacramento, CA 95825-1098 · (916) 569-8484

Phone(916) 569-8484

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMay 18, 2020

Last NPPES UpdateJuly 7, 20262 updates tracked since enumeration

NPPES CertifiedJuly 7, 2026

✔ NPI 1184246704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · 62028

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3701 J ST STE 201, Sacramento, CA 95816

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Victor Collazo Vidales Jr. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507227659

PECOS Enrollment IDI20231026000799

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95816 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.61 typical visit price

range $60.44 – $180.85

Typical copayment $23.15 (range $15.11 – $45.21)

Most-billed visit code 99203

Established Patient

$75.03 typical visit price

range $19.88 – $148.15

Typical copayment $18.75 (range $4.97 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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