Individual provider Active NPI

Carl Nelson, M.D.

  • Radiation Oncology Physician
  • Burlington, VT
National Provider Identifier
1043443518
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
0420012686 Issued in VT
Practice address
111 Colchester Ave
Dept of Radiation Oncology
Burlington, VT 05401-1473
Phone
(802) 847-3506
NPI assigned
Aug 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Radiation Oncology Physician 2085R0001X 0420012686 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Dept of Radiation Oncology
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
Dept of Radiation Oncology
Burlington, VT 05401-1473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130829000048 VT Practitioner - Radiation Oncology 9931342573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0420012686VTMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Feb 12, 2018 Accepting new patients

Locations

130 Fisher Rd
#286
Berlin, VT 05602

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

111 Colchester Ave
#L2
Burlington, VT 05401

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

160 Allen St
Rutland, VT 05701

Interoperability endpoints

  • Direct secure messaging: cnelson87513@direct.uvmhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1043443518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "DEPT OF RADIATION ONCOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "DEPT OF RADIATION ONCOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CARL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-31",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VT",
            "license": "0420012686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.