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ASHLEY RYAN VIDAD DO
NPI 1689324212
Student in an Organized Health Care Education/Training Program in Stockton, CA

Active since March 26, 2022PECOS EnrolledAccepts Medicare Assignment
4441 TIAMO WAY, STOCKTON, CA 95212(650) 307-7903 Get Directions Write a Review

NPPES record last updated: July 25, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ashley Ryan Vidad Do NPPES

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

ASHLEY RYAN VIDAD DO (NPI 1689324212) is an individual student in an organized health care education/training program in Stockton, California and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Redwood City, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1689324212
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameASHLEY RYAN VIDADCredential: DO
Location Address4441 TIAMO WAYStockton, CA 95212-2792
Mailing Address4441 Tiamo WayStockton, CA 95212-2792 · (650) 307-7903
Phone(650) 307-7903
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 26, 2022
Last NPPES UpdateJuly 25, 2022
NPPES CertifiedMarch 26, 2022
✔ NPI 1689324212 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.
4441 TIAMO WAY, Stockton, CA 95212
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Secondary Practice Location 1

Location 11102 Lyons StRedwood City, CA 94061-2263 · Phone (650) 307-7903

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

Ashley Ryan Vidad 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.

PECOS PAC ID5092205617
PECOS Enrollment IDI20251103002981
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.

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 Ashley Ryan Vidad's NPI number?

The NPI number for Ashley Ryan Vidad is 1689324212. It was assigned to this individual provider in the NPPES registry on March 26, 2022.

Where is Ashley Ryan Vidad located?

Ashley Ryan Vidad practices at 4441 Tiamo Way, Stockton, CA 95212. The listed phone number is (650) 307-7903.

What is Ashley Ryan Vidad's specialty?

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

Is Ashley Ryan Vidad enrolled in Medicare?

Yes. Ashley Ryan Vidad 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.

When was this NPI record last updated?

The NPPES record for Ashley Ryan Vidad was last updated on July 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.