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University of Vermont Medical Center Inc

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · S Burlington, VT

NPI 1013953280 · NPPES record last updated Feb 19, 2024

Key facts

NPI
1013953280
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
668 (VT)
Legal business name
UNIVERSITY OF VERMONT MEDICAL CENTER INC
Practice address
35 Joy Dr
S Burlington, VT 05403-6119
Phone
(802) 847-0000
NPI assigned
Jun 22, 2006
Organization subpart
No

Authorized official

Name
Richard J Vincent
Title
Interim Chief Financial Officer
Phone
(802) 847-2089

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 21

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1,208

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,208

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030313000004 VT Part a Provider - End-Stage Renal Disease Facility (ESRD) 3779491071 Practice locations: S Burlington, VT

National Provider Directory

Tax ID family
Fletcher Allen Healthcare (22 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 668 VT Yes

Addresses

Primary practice location

35 Joy Dr
S Burlington, VT 05403-6119

Mailing address

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Other identifiers

IdentifierTypeStateIssuer
0473503MedicaidVTJOY DR. RENAL

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Other providers in S Burlington, VT

All providers in S Burlington, VT · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Vermont

Sources for this page

Verify at the official NPI Registry.