LOGAN ROBERT VIDAL DO
NPI 1306133210
Family Medicine in San Diego, CA
About Logan Robert Vidal Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LOGAN ROBERT VIDAL DO (NPI 1306133210) is an individual family medicine provider in San Diego, California, licensed in Florida (OS12575) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Broadlawns Medical Center, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Logan Robert Vidal Do 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.
Medicare Billing Reassignments
2Medicare enrollment records show Logan Vidal reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Dallas Center, IA 50063
- Reassigned Medicare billing, Iowa enrollment
- 518 clinicians in this Medicare group
Marengo, IA 52301
- Reassigned Medicare billing, Iowa enrollment
- Also billed through NPI 1053368191 (Iowa)
- 75 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Broadlawns Medical Center
Acute Care Hospitals · Des Moines, IAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92161 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92161
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Logan Vidal's NPI number?
The NPI number for Logan Vidal is 1306133210. It was assigned to this individual provider in the NPPES registry on June 30, 2011.
Where is Logan Vidal located?
Logan Vidal practices at Vamc 3350 La Jolla Village Dr, San Diego, CA 92161. The listed phone number is (858) 552-8585.
What is Logan Vidal's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Logan Vidal enrolled in Medicare?
Yes. Logan Vidal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Logan Vidal's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Logan Vidal reassigns Medicare benefits to 2 organizations: Broadlawns Medical Center (Dallas Center, IA) and Marengo Memorial Hospital (Marengo, IA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Logan Vidal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Logan Vidal accept?
Health plans from Ambetter Health, Ambetter from Sunflower Health Plan, Medica and Wellmark Health Plan of Iowa, Inc. list Logan Vidal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Logan Vidal affiliated with any hospitals?
According to CMS data, Logan Vidal is affiliated with Broadlawns Medical Center.
When was this NPI record last updated?
The NPPES record for Logan Vidal was last updated on December 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Logan Robert Vidal, DO · NPI 1306133210
Family Medicine physician in San Diego, California. Individual provider, active in the CMS NPPES registry since June 30, 2011.
## Identity
- **NPI:** 1306133210 (Entity type: Individual)
- **Enumerated:** June 30, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** OS12575 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** VAMC 3350 LA JOLLA VILLAGE DR, San Diego, CA 92161-0001
- **Phone:** (858) 552-8585
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Broadlawns Medical Center (NPI 1467850727, Dallas Center, IA); Marengo Memorial Hospital (NPI 1356402929, Marengo, IA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** December 17, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1306133210) · Data from the CMS NPPES public registry.