Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Vidalis, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104245562

Benjamin Vidalis, MD is a Neurosurgery in Santa Fe, New Mexico. Graduated from Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University in 2014, 12 years ago. Practices with St Vincent Hospital, a 332-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
12
Trained at
Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University
Licensed in
NM
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

465 Saint Michaels Dr Ste 107
Santa Fe, NM 87505-7690
Phone: (505) 988-3233
Fax: (505) 988-3562
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Msc 10 5615, Albuquerque, NM 87131-0001 — (505) 272-3160

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence MD2021-0303 (NM)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NM)

Record details

NPI number1104245562
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 14, 2014
Last updated in NPPESSeptember 21, 2021
Certification dateSeptember 21, 2021
Mailing addressMsc 10 5615, University Of New Mexico, Albuquerque, NM 87131-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROSURGERY
Medical schoolCLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated 2014 (12 years in practice)
Group practice St Vincent Hospital — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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