DR. SAMUEL ARI VYDRO MD
NPI 1285375923
Student in an Organized Health Care Education/Training Program in San Francisco, CA

Q: What is Samuel Vydro's NPI number?

The NPI number for Samuel Vydro is 1285375923. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Q: What is Samuel Vydro's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Vydro was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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 April 06, 2022PECOS Enrolled

513 PARNASSUS AVE # S321, SAN FRANCISCO, CA 94143(415) 476-1239 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Sep 24, 2024, Apr 10, 2024 and 1 more (4 updates tracked since 2022).

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About Dr. Samuel Ari Vydro Md NPPES

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

DR. SAMUEL ARI VYDRO MD (NPI 1285375923) is an individual student in an organized health care education/training program in San Francisco, California and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285375923

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. SAMUEL ARI VYDROCredential: MD

Location Address513 PARNASSUS AVE # S321San Francisco, CA 94143-2205

Mailing Address513 Parnassus Ave # S321San Francisco, CA 94143-2205

Phone(415) 476-1239

Sole ProprietorNo

Enumeration DateApril 6, 2022

Last NPPES UpdateSeptember 11, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 24, 2024

✔ NPI 1285375923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

513 PARNASSUS AVE # S321, San Francisco, CA 94143

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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 (PECOS)

Dr. Samuel Ari Vydro Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

JONATHAN BERHANU EJIE

Student in an Organized Health Care Education/Training Program